This study reports on the long-term results of non-operative treatment for thoracic and lumbar burst fractures of the vertebrae. A burst fracture is caused by a high-energy load down through the spine. The vertebra breaks into tiny pieces. Bone fragments may move into the spinal canal or soft tissues around the spine.
All of the patients included had burst fractures of the thoracic or lumbar spine. Everyone was treated conservatively. No one had any neurologic problems associated with the burst fracture.
Patients were treated with bracing with or without bed rest. This was the standard of care for the patients injured early in the study. With the use of MRIs and CT scans today, some of those patients might have been treated surgically by the current standards.
Results were measured using pain levels, X-rays, function, and work capacity. X-rays showed the disc spaces and disc height as well as the position of the vertebrae. Results were gathered up to 41 years after the injury. This is the longest follow-up on record for spinal burst fractures treated nonoperatively.
Almost half of the patients (45 per cent) reported excellent results. They did not have any back pain or disability. One-third (33 per cent) had mild pain. Slightly more than 10 per cent had moderate pain. Another 11 per cent had severe pain with loss of function.
The authors concluded that patients with burst fractures do not have more back pain than adults of the same age who did not have a fracture. Conservative care for burst fractures of the spine in patients without neurologic problems is successful.
This holds true even years later and for patients whose discs were damaged at the time of the initial injury. Some patients may want to have surgery for faster pain relief and recovery. They may be able to return to work sooner with less short-term loss of function and income. But in the end (long-term), the results are the same.