BACKGROUND: To our knowledge, a prospective, randomized study comparing operative and nonoperative treatment of a thoracolumbar burst @entity174 in @entity1 without a @entity51 has never been performed. Our hypothesis was that operative treatment would lead to superior long-term clinical outcomes. METHODS: From 1994 to 1998, forty-seven consecutive @entity1 (thirty-two @entity1 and fifteen @entity1 ) with a stable thoracolumbar burst @entity174 and no @entity51 were randomized to one of two treatment groups: operative (posterior or anterior arthrodesis and instrumentation) or nonoperative treatment (application of a body cast or orthosis). Radiographs and computed tomography scans were analyzed for sagittal alignment and canal compromise. All @entity1 completed a questionnaire to assess any disability they may have had before the injury, and they indicated the degree of @entity158 at the time of presentation with use of a visual analog scale. The average duration of follow-up was forty-four months (minimum, twenty-four months). After treatment, @entity1 indicated the degree of @entity158 with use of the visual analog scale and they completed the Roland and Morris disability questionnaire, the @entity615 questionnaire, and the Short Form-36 (SF-36) health survey. RESULTS: In the operative group (twenty-four @entity1 ), the average @entity174 @entity1513 was 10.1 degrees at the time of admission and 13 degrees at the final follow-up evaluation. The average canal compromise was 39% on admission, and it improved to 22% at the final follow-up examination. In the nonoperative group (twenty-three @entity1 ), the average @entity1513 was 11.3 degrees at the time of admission and 13.8 degrees at the final follow-up examination after treatment. The average canal compromise was 34% at the time of admission and improved to 19% at the final follow-up examination. On the basis of the numbers available, no significant difference was found between the two groups with respect to return to work. The average @entity158 scores at the time of the latest follow-up were similar for both groups. The preinjury scores were similar for both groups; however, at the time of the final follow-up, those who were treated nonoperatively reported less disability. Final scores on the SF-36 and Oswestry questionnaires were similar for the two groups, although certain trends favored those treated without surgery. Complications were more frequent in the operative group. CONCLUSION: We found that operative treatment of @entity1 with a stable thoracolumbar burst @entity174 and normal findings on the neurological examination provided no major long-term advantage compared with nonoperative treatment.

Operative compared with nonoperative treatment of a thoracolumbar burst @entity174 without XXXX . A prospective, randomized study.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'men'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity1513 :: ('MESH:D007738', 'Disease') :: ['kyphosis'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficit'] @entity615 :: ('MESH:D001416', 'Disease') :: ['Oswestry back-pain'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity51 :: (MESH:D009461,Disease) :: ['neurological deficit']
