ArticleGlobal spine journal2022
Rate and Predictors of Failure in the Conservative Management of Stable Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis.
Article in Global spine journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- Predictors of failure of non-operative management in neurologically intact thoracolumbar burst fractures: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Anatomical and biological reconstruction of traumatic complete burst fractures of the thoracolumbar vertebrae using pedicle fixation combined with stent-armed kyphoplasty and intracorporeal bone grafting: technique rationale, 7-year experience and clinical, imaging, and histological outcomes.Journal of spine surgery (Hong Kong) · 2026Article
- Article
- Percutaneous Treatment of Traumatic A3 Burst Fractures of the Thoracolumbar Junction Without Neurological Impairment: The Role of Timing and Characteristics of Fragment Blocks on Ligamentotaxis Efficiency.Journal of clinical medicine · 2025Article
- 4 pedicle screw mono-segment versus 6 pedicle screw short-segment fixation in the treatment of thoracolumbar endplate fractures: finite element analysis and clinical follow-up.Frontiers in bioengineering and biotechnology · 2025Article
- Predictive accuracy of machine learning models for conservative treatment failure in thoracolumbar burst fractures.BMC musculoskeletal disorders · 2024Article
- The Comparison between Spinal Facet Joint Toothed Plate and Traditional Pedicle Screw-rod on Reduction of Thoracolumbar Fracture.Orthopaedic surgery · 2024Article
- Neurosurgery compared to orthopedic spine consultation: A single level I trauma center experience.Brain & spine · 2024Article
- Analysis of factors associated with the failure of treatment in thoracolumbar burst fractures treated with short-segment posterior spinal fixation.Journal of orthopaedic surgery and research · 2023Article
- Article
- Analysis of the Classification Systems for Thoracolumbar Fractures in Adults and Their Evolution and Impact on Clinical Management.Journal of clinical medicine · 2022Review
- Utility of upright radiographs in traumatic thoracolumbar fracture management.BMC musculoskeletal disorders · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designSystematic review.
objectivesManagement of stable traumatic thoracolumbar burst fractures in neurologically-intact patients remains controversial. Conservative management fails in a subset of patients who require subsequent surgical fixation. The aim of this review is to (1) determine the rate of conservative management failure, and (2) analyze predictive factors at admission influencing conservative management failure.
methodsA systematic review adhering to PRISMA guidelines was performed. Studies with data pertaining to traumatic thoracolumbar burst fractures without posterior osteoligamentous injury (e.g. AO Type A3/A4) and/or the rate and predictive factors of conservative management failure were included. Risk of bias appraisal was performed. Pooled analysis of rates of failure was performed with qualitative analysis of predictors of conservative management failure.
results16 articles were included in this review (11 pertaining to rate of conservative management failure, 5 pertaining to predictive risk factors). Rate of failure of conservative management from a pooled analysis of 601 patients is 9.2% (95% CI: 4.5%-13.9%). Admission factors predictive of conservative management failure include age, greater initial kyphotic angle, greater initial interpedicular distance, smaller initial residual canal size, greater Load Sharing Classification (LSC) score and greater admission Visual Analog Scale (VAS) pain scores.
conclusionA proportion (9.2%) of conservatively managed, neurologically-intact thoracolumbar burst fractures fail conservative management. Among other factors, age, kyphotic angle, residual canal area and interpedicular distance should be investigated in prospective studies to identify the subset of patients prone to failure of conservative management. Surgical management should be carefully considered in patients with the above risk factors.
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