Spine (Phila Pa 1976). 2026 Apr 9. doi: 10.1097/BRS.0000000000005688. Online ahead of print.
ABSTRACT
STUDY DESIGN: Prospective observational multicenter cohort study.
OBJECTIVE: To evaluate and compare functional outcomes, as measured by AO Spine Patient Reported Outcome Spine Trauma (PROST), in neurologically intact patients with thoracolumbar (TL) burst fractures treated operatively or nonoperatively.
SUMMARY OF BACKGROUND DATA: The optimal management of these patients remains debated.
METHODS: This investigation was part of a prospective observational international multicenter cohort study. Neurologically intact adults (18-65 y) with acute (≤10 d) TL burst fractures were included from various sites across the world. Provided treatment was determined by the local standard of care. PROST was administered at multiple prospective timepoints from baseline up to 2-years post-injury. Descriptive statistics were used to analyze patient and clinical characteristics. Multivariable mixed models for repeated measures were used to assess differences in treatment groups and between the fracture types.
RESULTS: A total of 93 patients were included (mean age 41 y, 57% male). Most sustained high-energy trauma (73.1%) and had type A3 fractures (63.4%), with 61.3% treated nonoperatively. Both nonsurgical (34.2 to 86.0) and surgical (39.9 to 85.6), as well as fracture types (A4: 38.4 to 85.6; A3: 36.4 to 87.3) demonstrated significant improvements in PROST scores over time (P<0.001). No statistically significant differences in PROST scores were found between treatment groups or fracture types. Although, surgically treated patients showed higher PROST scores within the first 3 months, and nonsurgical patients had marginally higher scores hereafter, these differences were not statistically significant and converged by 2 years.
CONCLUSION: Both surgical and nonsurgical treatment of neurologically intact TL burst fracture patients resulted in comparable long-term functional outcomes as measured by AO Spine PROST. A descriptive trend was observed with surgically treated patients showing higher mean PROST scores up to 3 months post-treatment, however, between-group differences were not statistically significant and equalized by two years.
PMID:41954890 | DOI:10.1097/BRS.0000000000005688
