Abstract
ABSTRACT Objective: To identify the category of evidence and the strength of recommendation for the conservative treatment of thoracolumbar spine burst fractures. Method: A systematic review was conducted from April 2014 to June 2015, selecting articles according to their prospective design, related to thoracolumbar spine burst fractures and their treatment. These studies were published in the electronic bibliographic databases from January 2009 to January 2015. Results: A total of 9,504 articles were found in a free search, of which 7 met the selection criteria and were included for analysis in a study of a total of 435 patients, of whom 72 underwent surgical treatment and 363 received some type of conservative treatment, showing predominantly level of evidence "1b", with strength of recommendation type "A". Conclusions: According to the evidence obtained, the conservative treatment is a choice for patients with stable burst fracture in a single level of thoracolumbar spine and with no neurological injury.
Highlights
IntroductionIn Mexico, the most affected vertebrae are those found between T11 and L1 (in 52% of cases), 45% of which are secondary to burst type lesions caused mainly by falls (in 50.5%).[1, 3,4,5]
These seven articles evaluated in the final selection reviewed a total of 435 patients, 72 of whom were managed surgically and 363 of whom received some type of conservative treatment
The evidence found shows a disparity in the general results, in that, while there are data that indicate similar results in patients who underwent surgical treatment (24 patients) and conservative treatment (23 patients) for stable burst fractures at a single level of the thoracolumbar spine without neurological damage, another source of evidence generated from a review of 78 patients divided into three groups indicated that minimally invasive surgery produced better patient results as compared to traditional surgical treatment and conservative management
Summary
In Mexico, the most affected vertebrae are those found between T11 and L1 (in 52% of cases), 45% of which are secondary to burst type lesions caused mainly by falls (in 50.5%).[1, 3,4,5]. The presumptive diagnosis can be supported by imaging studies.[1,3,6] The combination of simple radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and myelography allow the identification of bone, ligament, and nerve lesions. The information obtained from these studies will make it possible to classify the type of osteoarticular injury and identify unstable injuries, as well as to support a therapeutic decision and the appropriate planning for stabilization of the bone elements, depending on the case.[1,3,6,7]
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