ArticleGlobal spine journal2024
The Influence of Comminution and Posterior Ligamentous Complex Integrity on Treatment Decision Making in Thoracolumbar Burst Fractures Without Neurologic Deficit?
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 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- [Indications for surgical treatment of traumatic fractures of the thoracic spine and lumbar spine].Unfallchirurgie (Heidelberg, Germany) · 2025Guideline
- Comparative analysis of two modified TLICS systems in guiding surgical decision-making for thoracolumbar fractures.Frontiers in surgery · 2026Article
- Development and validation of a radiomics model using plain radiographs to predict spine fractures with posterior wall injury.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 · 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
- [Current surgical treatment concepts for traumatic thoracic and lumbar vertebral fractures in adults with good bone quality].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- 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
24 authors at 14 institutions in 11 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designA prospective study.
objectiveto evaluate the impact of vertebral body comminution and Posterior Ligamentous Complex (PLC) integrity on the treatment recommendations of thoracolumbar fractures among an expert panel of 22 spine surgeons.
methodsA review of 183 prospectively collected thoracolumbar burst fracture computed tomography (CT) scans by an expert panel of 22 trauma spine surgeons to assess vertebral body comminution and PLC integrity. This study is a sub-study of a prospective observational study of thoracolumbar burst fractures (Spine TL A3/A4). Each expert was asked to grade the degree of comminution and certainty about the PLC disruption from 0 to 100, with 0 representing the intact vertebral body or intact PLC and 100 representing complete comminution or complete PLC disruption, respectively.
results≥45% comminution had a 74% chance of having surgery recommended, while <25% comminution had an 86.3% chance of non-surgical treatment. A comminution from 25 to 45% had a 57% chance of non-surgical management. ≥55% PLC injury certainity had a 97% chance of having surgery, and ≥45-55% PLC injury certainty had a 65%. <20% PLC injury had a 64% chance of having non-operative treatment. A 20 to 45% PLC injury certainity had a 56% chance of non-surgical management. There was fair inter-rater agreement on the degree of comminution (ICC .57 [95% CI 0.52-.63]) and the PLC integrity (ICC .42 [95% CI 0.37-.48]).
conclusionThe study concludes that vetebral comminution and PLC integrity are major dterminant in decision making of thoracolumbar fractures without neurological deficit. However, more objective, reliable, and accurate methods of assessment of these variables are warranted.
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