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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(01): 042-047
DOI: 10.1055/s-0042-1749622
Artigo Original
Coluna

Comparison Between Surgical and Conservative Treatment for AOSpine Type A3 and A4 Thoracolumbar Fractures without Neurological Deficit: Prospective Observational Cohort Study

Artikel in mehreren Sprachen: português | English
Emiliano Neves Vialle 
1   Grupo de Cirurgia da Coluna, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil
,
Asdrubal Falavigna 
2   Serviço de Ortopedia e Traumatologia, Universidade de Caxias do Sul (UCS), Caxias do Sul, RS, Brasil
,
André de Oliveira Arruda 
1   Grupo de Cirurgia da Coluna, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil
,
Joana Bretas Cabral Rondon Guasque 
1   Grupo de Cirurgia da Coluna, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil
,
Bárbara Miroski de Oliveira Pinto 
1   Grupo de Cirurgia da Coluna, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil
,
Guilherme Finger 
3   Departamento de Neurocirurgia, Hospital Cristo Redentor, Porto Alegre, Brasil
,
Ericson Sfreddo 
3   Departamento de Neurocirurgia, Hospital Cristo Redentor, Porto Alegre, Brasil
,
André Martins de Lima Cecchini 
3   Departamento de Neurocirurgia, Hospital Cristo Redentor, Porto Alegre, Brasil
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Abstract

Objective To compare the clinical results between conservative (CS) and surgical treatment (CXS) of A3 and A4 fractures without neurological deficit.

Methods Prospective observational study of patients with thoracolumbar fractures type A3 and A4. These patients were separated between the surgical and conservative groups, and evaluated sequentially through the numeric rating scale (NRS), Roland-Morris disability questionnaire (RMDQ), EuroQol-5D (EQ-5D) quality of life questionnaire, and Denis work scale (DWS) up to 2.5 years of follow-up.

Results Both groups showed significant improvement, with no statistical difference in pain questionnaires (NRS: CXS 2.4 ± 2.6; CS 3.5 ± 2.6; p > 0.05), functionality (RMDQ: CS 7 ± 6.4; CXS 5.5 ± 5.2; p > 0.05), quality of life (EQ-5D), and return to work (DWS).

Conclusion Both treatments are viable options with equivalent clinical results. There is a tendency toward better results in the surgical treatment of A4 fractures.

Keywords

internal fixation fracture - spinal fractures - treatment outcome - conservative treatment

Financial Support

This study had financial and logistical support from AOSpine Latin America.


Multicenter work developed at the Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR and the Hospital Cristo Redentor, Porto Alegre, RS, Brazil.




Publikationsverlauf

Eingereicht: 23. Oktober 2021

Angenommen: 28. April 2022

Artikel online veröffentlicht:
24. März 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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