Spinal Fracture Outcome Same With or Without Surgery

But neurologic recovery patterns may differ

THURSDAY, April 24 (HealthDay News) -- Over the medium to long term, operative and nonoperative treatment for traumatic thoracic and lumbar spinal fractures result in similar overall outcomes, according to a study published in the April 20 issue of Spine.

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Agnita Stadhouder, M.D., and colleagues at University Medical Centre in Utrecht, Netherlands, analyzed data on 636 patients treated at two trauma centers between 1991 and 2002. For each patient included in the study, there was a disagreement over the best course of treatment when orthopedic surgeons blinded to the actual treatment assessed each case.

There was discordance over the course of treatment for 190 patients, including 95 who were treated nonoperatively and 95 who underwent operative treatment. Baseline characteristics for the two groups of patients were similar, although the operative group had a higher proportion of males and a higher degree of neurologic impairment. The complication rates for the nonoperative and operative groups were 17 percent and 21 percent, respectively. Follow-up for a mean 6.2 years revealed similar pain scores, disability indexes and general health outcomes for the two groups.

"Studies on the cost-effectiveness of treatment options and the patterns of recovery within 2 years after injury would assist in guideline development and stimulate interest for future research," the authors write. "Optimal treatment of these patients, even if expensive, may yield considerable benefits to their communities."

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