Congress of Neurological Surgeons Systematic Overview and Proof-Based mostly Tips on the Analysis and Remedy of Sufferers with Thoracolumbar Backbone Trauma: Operative Versus Nonoperative Remedy.
Neurosurgery. 2018 Sep 06;:
Authors: Rabb CH, Hoh DJ, Anderson PA, Arnold PM, Chi JH, Dailey AT, Dhall SS, Eichholz KM, Harrop JS, Qureshi S, Raksin PB, Kaiser MG, O’Toole JE
QUESTION 1: Does the surgical remedy of burst fractures of the thoracic and lumbar backbone enhance medical outcomes in comparison with nonoperative remedy?
RECOMMENDATION 1: There’s conflicting proof to advocate for or in opposition to the usage of surgical intervention to enhance medical outcomes in sufferers with thoracolumbar burst fracture who’re neurologically intact. Due to this fact, it is strongly recommended that the discretion of the treating supplier be used to find out if the presenting thoracic or lumbar burst fracture within the neurologically intact affected person warrants surgical intervention. Energy of Advice: Grade Inadequate.
QUESTION 2: Does the surgical remedy of nonburst fractures of the thoracic and lumbar backbone enhance medical outcomes in comparison with nonoperative remedy?
RECOMMENDATION 2: There’s inadequate proof to advocate for or in opposition to the usage of surgical intervention for nonburst thoracic or lumbar fractures. It’s endorsed that the choice to pursue surgical procedure for such fractures be on the discretion of the treating doctor. Energy of Advice: Grade Inadequate The complete model of the rule will be reviewed at: https://www.cns.org/guideline-chapters/congress-neurological-surgeons-systematic-review-evidence-based-guidelines/chapter_1.
PMID: 30203034 [PubMed – as supplied by publisher]