ArticleGlobal spine journal2024
Expert Opinion, Real-World Classification, and Decision-Making in Thoracolumbar Burst Fractures Without Neurologic Deficits?
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 5 papers.
What it found
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Who cites it
5 citing papers in PubMed.
- 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
- The AO Spine Knowledge Forums: A Decade of Impactful Spine Research.Global spine journal · 2025Article
- Applications of the SpineJack device in the surgical management of type A4 lumbar burst fractures without neurological deficit: illustrative cases.Journal of neurosurgery. Case lessons · 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
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designRetrospective analysis of prospectively collected data.
objectivesTo compare decision-making between an expert panel and real-world spine surgeons in thoracolumbar burst fractures (TLBFs) without neurological deficits and analyze which factors influence surgical decision-making.
methodsThis study is a sub-analysis of a prospective observational study in TL fractures. Twenty two experts were asked to review 183 CT scans and recommend treatment for each fracture. The expert recommendation was based on radiographic review.
resultsOverall agreement between the expert panel and real-world surgeons regarding surgery was 63.2%. In 36.8% of cases, the expert panel recommended surgery that was not performed in real-world scenarios. Conversely, in cases where the expert panel recommended non-surgical treatment, only 38.6% received non-surgical treatment, while 61.4% underwent surgery. A separate analysis of A3 and A4 fractures revealed that expert panel recommended surgery for 30% of A3 injuries and 68% of A4 injuries. However, 61% of patients with both A3 and A4 fractures received surgery in the real world. Multivariate analysis demonstrated that a 1% increase in certainty of PLC injury led to a 4% increase in surgery recommendation among the expert panel, while a .2% increase in the likelihood of receiving surgery in the real world.
conclusionSurgical decision-making varied between the expert panel and real-world treating surgeons. Differences appear to be less evident in A3/A4 burst fractures making this specific group of fractures a real challenge independent of the level of expertise.
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Registered trials
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