Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Evaluation of functional outcomes and return to work in thoracolumbar junction fractures (T11-L2) following posterior spinal fusion: A prospective observational study.
Observational study in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeFractures at the thoracolumbar junction (T11-L2) represent a critical spinal trauma pattern due to biomechanical transition zones. Treatment decisions, especially between conservative and surgical approaches like posterior spinal fusion (PSF), remain debated. This study evaluates the functional, neurological, and occupational outcomes of patients treated with or without PSF.
methodsA prospective cohort of 80 patients with thoracolumbar junction fractures was followed for 9 months at a tertiary trauma referral center. Fifty-five patients received PSF, and 25 underwent non-surgical management. Outcomes assessed included kyphosis correction (Cobb's angle), American Spinal Injury Association (ASIA) motor score, Oswestry Disability Index (ODI), and return-to-work (RTW) proportion. Statistical methods included Wilcoxon signed-rank tests, chi-square tests, and multivariate logistic regression.
resultsSurgically treated patients showed significant kyphotic correction (mean change: +1.93°, p = 0.0013) and greater neurological improvement (mean ASIA gain: +6.91 vs. +2.00, p < 0.001). Surprisingly, ODI scores worsened in surgical patients (+ 3.89, p < 0.001) and showed no significant change in the non-surgical group. RTW was significantly higher in the surgical group at 6 and 9 months (75% vs. 32% and 93% vs. 64%, respectively). Multivariate analysis identified surgery as the only independent predictor of RTW at 9 months (OR = 8.96, p = 0.021).
conclusionPosterior spinal fusion was associated with improved kyphosis correction, neurological recovery, and return-to-work at 9 months. However, disability scores did not improve and in some cases worsened, highlighting the importance of patient selection and postoperative rehabilitation.
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