ArticleEuropean journal of medical research2025
Nomogram that can predict failure of conservative treatment for thoracolumbar burst fracture was established.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Predictors of failure of non-operative management in neurologically intact thoracolumbar burst fractures: a systematic review and meta-analysis.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 · 2026Review
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify predictors of failure of conservative management for thoracolumbar burst fracture (TBF) and to develop and validate a nomogram for risk stratification.
methodsWe analyzed 152 patients with TBF treated conservatively at our center from December 2020 to December 2024. Patients were categorized into the Successful Received Conservative Treatment (SRCT) group (n = 120) and the Converted to Surgical Treatment (CST) group (n = 32). Risk factors for conversion were assessed using univariate and multivariate logistic regression. A nomogram was constructed from the final model and internally validated with 1000 bootstrap resamples. Model performance was evaluated by discrimination [area under the receiver operating characteristic curve (AUC)], calibration, and clinical utility [decision curve analysis (DCA) and clinical impact curve (CIC)].
resultsAge, interpedicular distance, canal compromise, and local kyphosis angle were independent predictors of CST (all p < 0.05). The nomogram showed good discrimination (AUC 0.850, 95% CI 0.774-0.926) and calibration (mean absolute error 0.02). DCA indicated clinical benefit across threshold probabilities of 0.05-0.75, and CIC supported its utility for identifying high-risk patients.
conclusionsAge, interpedicular distance, canal compromise, and local kyphosis angle are independent predictors of CST. The internally validated nomogram offers individualized risk estimates and may aid early identification of patients at high risk of surgical conversion; external validation is needed.
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