Thoracolumbar compression and burst fractures

Summary

There is insufficient evidence from three small retrospective cohort studies to suggest that bracing or casting can improve outcomes in adults with thoracolumbar burst or compression fractures compared with no bracing or casting. Overall, no differences were found between the two treatment groups regarding functional status, physical impairment, patient-reported pain, or radiographic measures. A wide variety of outcome measures using different assessment tools were used making comparisons between studies difficult. Some studies were limited by small sample sizes and inadequate follow-up. Since treatment may have been influenced by patient presentation and / or physician preferences, results may be biased as treatment groups may not be similar. Randomized or methodologically rigorous comparative studies with larger populations, more complete follow-up, and standardized outcome measures are necessary to evaluate the efficacy of bracing or casting for thoracolumbar fractures.