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Research ArticleLumbar Spine

Radiographic Outcomes Following Various Treatment Options of Thoracolumbar Burst Fractures

Vikas Parmar, Evalina Bond, Paul S. Page and Darnell T. Josiah
International Journal of Spine Surgery March 2023, 8427; DOI: https://doi.org/10.14444/8427
Vikas Parmar
1 Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH, USA
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Evalina Bond
2 Department of Surgery, University of Wisconsin, Madison, WI, USA
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Paul S. Page
3 Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
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Darnell T. Josiah
3 Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
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Article Figures & Data

Tables

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    Table 1

    Breakdown of patient population by treatment group.

    Treatment GroupNumber of Patients (% of Total)
    Nonoperative treatment
     Total122
     Successful117 (70.5%)
     Failed5 (3.0%)
    Operative treatment
     Total44
     Single-level fusion4 (2.4%)
     Multilevel fusion28 (16.9%)
     Corpectomy12 (7.2%)
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    Table 2

    Patient characteristics by treatment group.

    VariableNonoperative (n = 117)Single Fusion (n = 4)Multilevel Fusion (n = 28)Corpectomy (n = 12)Delayed Surgery (n = 5) P Value
    Age, y, mean (SD)57.2 (20)47 (10.4)44 (18.4)46.5 (15.6)48.6 (6.9)0.010
    Sex
     Men57 (48.7%)2 (50%)19 (67.9%)8 (66.7%)1 (20%)0.170
     Women60 (51.3%)2 (50%)9 (32.1%)4 (33.3%)4 (80%)
    Body mass index, mean (SD)26.6 (6.9)28.5 (3.1)27.5 (4.9)26.4 (3.6)27 (6.1)0.947
    Level
     T116 (5.1%)0 (0%)3 (10.7%)0 (0%)1 (20%)0.150
     T1224 (20.5%)2 (50%)8 (28.6%)3 (25%)3 (60%)
     L166 (56.4%)0 (0%)10 (35.7%)6 (50%)1 (20%)
     L221 (17.9%)2 (50%)7 (25%)3 (25%)0 (0%)
    Smoker
     Never75 (64.1%)3 (75%)17 (60.7%)7 (58.3%)4 (80%)0.978
     Former14 (12%)0 (0%)2 (7.1%)2 (16.7%)0 (0%)
     Current28 (23.9%)1 (25%)9 (32.1%)3 (25%)1 (20%)
    Placement
     Home73 (62.4%)3 (75%)20 (71.4%)9 (75%)3 (60%)0.834
     Rehabilitation44 (37.6%)1 (25%)8 (28.6%)3 (25%)2 (40%)
    Neurologic deficit
     Intact117 (100%)4 (100%)26 (92.9%)9 (75%)5 (100%)0.001
     Deficit0 (0%)0 (0%)2 (7.1%)3 (25%)0 (0%)
    Osteopenia/osteoporosis
     None73 (62.4%)4 (100%)22 (78.6%)9 (75%)5 (100%)0.729
     Osteopenia19 (16.2%)0 (0%)2 (7.1%)1 (8.3%)0 (0%)
     Osteoporosis25 (21.4%)0 (0%)4 (14.3%)2 (16.7%)0 (0%)
    Corticosteroid use
     No108 (92.3%)4 (100%)26 (92.9%)12 (100%)5 (100%)>0.99
     Yes9 (7.7%)0 (0%)2 (7.1%)0 (0%)0 (0%)
    • Note: Data presented as n (%) unless otherwise indicated. Analysis of variance test conducted on all patient treatment groups with a significance threshold of P = 0.05 demonstrating when there is a significant difference in the mean between the groups.

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    Table 3

    Kyphotic angle change over time.

    Patient No.Treatment TypeInitial (°)1 y (°) P ValueChange (°)
    4Short segment15.8 ± 10.918.2 ± 6.90.73−2.4
    28Multilevel14.9 ± 8.311.6 ± 7.90.133.3
    12Corpectomy18.5 ± 7.44.4 ± 8.5 <0.001 14.1
    5Delayed12.8 ± 7.621.2 ± 11.10.21−8.4
    117Nonsurgical11.6 ± 7.217.7 ± 7.3 <0.001 −6.1
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    Table 4

    Cobb angle change over time.

    Patient No.Treatment TypeInitial (°)1 y (°) P ValueChange (°)
    4Short segment−11.9 ± 9.1−18.0 ± 12.20.46−6.1
    28Multilevel−15.5 ± 9.5−12.8 ± 8.60.282.7
    12Corpectomy−15.1 ± 8.77−8.3 ± 10.40.0987.6
    5Delayed−14.3 ± 4.9−22.4 ± 13. 70.27−8.1
    117Nonsurgical−11.1 ± 7.4−17.4 ± 9.2 <0.001 −6.4
    • View popup
    Table 5

    Gardner angle change over time.

    Patient No.Treatment TypeInitial (°)1 y (°) P ValueChange (°)
    4Short segment17.3 ± 4.724.1 ± 5.10.099−6.8
    28Multilevel16.8 ± 9.414.2 ± 8.30.282.6
    12Corpectomy22.3 ± 7.011.3 ± 9.5 0.004 11.0
    5Delayed14.8 ± 7.523.3 ± 13.20.26−8.5
    117Nonsurgical13.9 ± 7.921.9 ± 8.3 <0.001 −8.1
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Radiographic Outcomes Following Various Treatment Options of Thoracolumbar Burst Fractures
Vikas Parmar, Evalina Bond, Paul S. Page, Darnell T. Josiah
International Journal of Spine Surgery Mar 2023, 8427; DOI: 10.14444/8427

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Radiographic Outcomes Following Various Treatment Options of Thoracolumbar Burst Fractures
Vikas Parmar, Evalina Bond, Paul S. Page, Darnell T. Josiah
International Journal of Spine Surgery Mar 2023, 8427; DOI: 10.14444/8427
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