PT  - JOURNAL ARTICLE
AU  - Parmar, Vikas
AU  - Bond, Evalina
AU  - Page, Paul S.
AU  - Josiah, Darnell T.
TI  - Radiographic Outcomes Following Various Treatment Options of Thoracolumbar Burst Fractures
AID  - 10.14444/8427
DP  - 2023 Mar 09
TA  - International Journal of Spine Surgery
PG  - 8427
4099  - https://www.ijssurgery.com/content/early/2023/03/08/8427.short
4100  - https://www.ijssurgery.com/content/early/2023/03/08/8427.full
AB  - Background Thoracolumbar burst fractures include a spectrum of treatment options ranging from conservative management to multilevel fusion with or without corpectomy. Given the variability of treatment options, consideration of radiographic outcomes with different treatment modalities should be a critical consideration in management.Methods A retrospective review was conducted evaluating all patients presenting with spine fractures over a 7-year period. Inclusion criteria were limited to adults with acute, traumatic burst fractures of the thoracolumbar joint levels T11-L2. Patients were categorized by nonoperative management, short-segment fusion, multilevel fusion without anterior column reconstruction, and corpectomy. Radiographic information collected included kyphotic angle (KA), Cobb angle (CA), and Gardner angle (GA).Results In total, 117 patients (70.5%) were successfully treated nonoperatively, 4 (2.4%) underwent short-segment fusion, 28 (16.9%) underwent multilevel fusion, and 12 (7.2%) underwent corpectomy. All nonoperative patients demonstrated significantly worse kyphosis at 1-year follow-up as measured by KA, CA, and GA (P < 0.001). Patients undergoing corpectomy had the largest improvement in kyphosis with an average improvement of 14.1° on KA, 8.1° on CA, and 11.0° on GA (P < 0.001, P = 0.098, and P = 0.004, respectively). In comparison, patients undergoing multilevel fusion showed an average improvement of 2.6°, 2.7°, and 3.3° of correction on GA, CA, and KA, respectively (P > 0.05).Conclusions Nonoperative and short-segment fusion burst fracture patients demonstrated significantly worse kyphosis at 1-year follow-up. Patients undergoing corpectomy demonstrated a superior improvement in kyphotic correction compared with those undergoing multilevel fusion and short-segment fusion.Level of Evidence 3.