Non operative treatment versus posterior fixation for thoracolumbar burst fractures without neurologic deficit

ABSTRACT

A Prospective study was conducted to compare the results of non operative treatment versus short- segment posterior fixation using pedicle screws for thoracolumbar burst fractures without neurologic deficit . This study involved 40 patients. Neurologically intact patients with single - level closed burst fracture involve T 11 - L2 were included in the study . Patients in the non operative group were allowed activity to the point of pain tolerance beginning on the day of injury using hyperextension brace . Patients in the operative group underwent two levels [one above and one below] fixation using transpedicuar screws. The follow up period was 1 year. The surgical group had less pain up to 3 months and a better outcome up to 6 months, but the outcome was similar afterward. No neurologic deficit developed in any patient . In the non operative group, the kyphosis angle worsened by 4o and retropulsion decreared from 35% to 15%. Short - segment posterior fixation provides partial kyphosis correction and earlier pain relief but functional outcome at 1 year is similar in both groups