ArticleNeurosurgery2025
Gender Differences in Outcomes in Patients Treated for Thoracolumbar Burst Fractures Without Neurological Deficits: Prospective International Multicenter Study.
Article in Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Minimal Clinically Important Difference (MCID) and Long-Term Prospective Validation of the AO Spine PROST (Patient Reported Outcome Spine Trauma).Global spine journal · 2026Article
- How can we promote gender and sex equality in orthopaedics and traumatology surgery? Research avenues perspectives.Journal of orthopaedic surgery and research · 2025Review
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
BACKGROUND AND
objectivesExploring gender differences in outcomes after spinal surgery is essential. We aimed to assess gender differences in patients treated for thoracolumbar burst fractures without neurological deficit regarding Oswestry Disability Index (ODI) improvement. Secondarily, we assessed baseline characteristics, treatment selection, and other patient-reported outcomes.
methodsData were prospectively collected. The primary end point was defined as time to achieve minimal clinically important difference (MCID) in ODI. In an exploratory analysis, we defined improvement in ODI as reaching minimal disability.
resultsGenders had similar baseline characteristics, injury characteristics, and treatment selection and timing.Surgically treated women showed a faster achievement of MCID in ODI (14 days, 95% CI 14.0-28.0 vs 28 days, 95% CI 15.0-34.0, P = .009). On multivariable modeling, nonoperatively treated women had a lower chance of achieving improvement in the ODI than nonoperatively treated men (hazard ratio 0.55, 95% CI: 0.32-0.96, P = .036).Women had a longer median time to achieve minimal disability (102.0 days, 95% CI: 76.0; 131.0 vs 62.0 days, 95% CI: 51.0; 72.0, P = .008). Nonoperative women had a longer median time to achieve minimal disability (130.0 days, 95% CI: 82.0-185.0 vs 61.0 days, 95% CI: 47.0-76.0, P = .048). On multivariable modeling, nonoperative women had a lower chance for achieving minimal disability than nonoperatively treated men (hazard ratio 0.55, 95% CI 0.31-0.98 P = .042).
conclusionThis novel study reports gender differences in thoracolumbar burst fractures in neurologically intact patient. Women do worse with nonoperative management than men. In addition, women do better with operative than nonoperative management in achieving MCID, whereas this was not observed in men. Thus, women benefit to a greater extent from surgical management than do men. These results highlight the importance of personalized treatment that incorporates gender. Future studies should assess gender differences in other traumatic spinal pathologies.
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