ArticleGlobal spine journal2024
What Factors Influence Surgeons in Decision-Making in Thoracolumbar Burst Fractures? A Survey-Based Investigation of a Panel of Spine Surgery Experts.
Article in Global spine journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Treatment strategies for incomplete burst fractures (AO Spine A3) at the thoracolumbar junction -results of a nationwide German survey.Brain & spine · 2026Article
- Nomogram that can predict failure of conservative treatment for thoracolumbar burst fracture was established.European journal of medical research · 2025Article
- Anterior column reconstruction with mono-segmental fusion and lag screw fixation of sagittal split for burst-split fracture of the thoracolumbar spine.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Summary and Future Strategies in Anticipation of the A3 A4 Fracture Study Results.Global spine journal · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designCross-sectional survey study.
objectiveTo investigate factors affecting decision-making in thoracolumbar burst-fractures without neurologic deficit.
methodsA 40-question survey addressing expert-related, economic, and radiological factors was distributed to 30 international trauma experts. Descriptive statistics were used to assess the impact of these factors on operative or non-operative management preferences.
resultsOut of 30 experts, 27 completed the survey. The majority of respondents worked at level 1 trauma centers (81.5%) within university settings (77.8%). They were primarily orthopedic surgeons (66.7%) and had over 10 years of experience (70.4%). About 81% found distinguishing between A3 and A4 fractures relevant for decision-making. Most experts (59%) treated A3 fractures non-surgically, while only 30% treated A4 fractures conservatively. Compensation systems did not influence treatment recommendations, and hospital measures promoting surgeries did not significantly affect distribution. Radiological factors, such as local kyphosis (25/27), fracture comminution (23/27), overall sagittal balance (21/27), and spinal canal narrowing (20/27), influenced decisions.
conclusionIncomplete burst fractures (A3) are predominantly treated non-surgically, while complete burst fractures (A4) are primarily treated surgically. Compensation, third-party incentives, and outpatient care did not significantly impact decision-making. Radiological factors beyond the AO Spine thoracolumbar classification system seem to be essential and warrant further evaluation.
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Registered trials
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