Examination of Thoracolumbar Burst Fractures with a Thoracolumbar Injury Classification and Severity Score of 4

Abstract

Introduction: It is often difficult to determine the treatment option for thoracolumbar burst fractures with a Thoracolumbar Injury Classification and Severity Score of 4 (TLICS 4).

Methods: We retrospectively reviewed and compared six patients who underwent conservative treatment and nine patients who underwent surgical treatment for thoracolumbar burst fracture with TLICS 4.

Results: Vertebral body height loss was significantly less and bed rest duration was significantly shorter in the operation group. There were no significant between-group differences in local kyphosis, Denis pain scale score, and neurological symptoms.

Conclusions: We found that conservative treatment in TLICS 4 provides favorable outcomes, but surgical treatment provides the advantages of early ambulation and the prevention of deformity in the damaged vertebral body.