Surgical versus Non-Surgical Treatment of Thoracolumbar Burst Fractures in Neurologically Intact Patients: A Prospective International Multicentre Cohort Study.

Authors

• Marcel F Dvorak
• Cumhur F Öner
• Charlotte Dandurand
• Klaus John Schnake
• Richard J Bransford
• Eugen Cezar Popescu
• Mohammed El-Sharkawi
• Shanmuganathan Rajasekaran
• Lorin M Benneker
• Greg D Schroeder
• Jin W Tee
• John C France
• Jérôme Paquet
• Richard Allen
• William F Lavelle
• Miguel Hirschfeld
• Spyros Pneumaticos
• Emiliano Vialle
• Alexander R Vaccaro

Publication/Presentation Date

1-1-2026

Abstract

Study designProspective cohort study.ObjectivesTreatment for thoracolumbar (TL) burst fractures in neurologically intact patients remains controversial. The goal of this study was to utilize the international equipoise to determine whether surgery leads to a more rapid improvement of disability measured by minimal clinically important difference (MCID) in Oswestry Disability Index (ODI).MethodsThe primary endpoint was time to achieve an improvement in ODI of more than 12.8 points within 1 year after baseline (MCID). A post hoc analysis was conducted to assess time to minimal disability (ODI of < 20). Time-to-event analyses were applied, including log rank test for equality of survivor functions, Kaplan Meier survival curves and Cox proportional hazard models.ResultsOne hundred and ninety-eight patients were included (122 surgical and 76 non-surgical patients). Median time to achieve MCID in ODI (12.8 points) from baseline was similar between the two groups (25.0 days vs 25.5 days,

Volume

16

Issue

1

First Page

628

Last Page

638

ISSN

2192-5682

Published In/Presented At

Dvorak, M. F., Öner, C. F., Dandurand, C., Schnake, K. J., Bransford, R. J., Popescu, E. C., El-Sharkawi, M., Rajasekaran, S., Benneker, L. M., Schroeder, G. D., Tee, J. W., France, J. C., Paquet, J., Allen, R., Lavelle, W. F., Hirschfeld, M., Pneumaticos, S., Vialle, E., & Vaccaro, A. R. (2026). Surgical versus Non-Surgical Treatment of Thoracolumbar Burst Fractures in Neurologically Intact Patients: A Prospective International Multicentre Cohort Study. Global spine journal, 16(1), 628–638. https://doi.org/10.1177/21925682251356910

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

40605521

Department(s)

Administration and Leadership

Document Type

Article