COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT OF LUMBAR BURSTFRACTURES

The outcomes of traumatic two-and three-column lumbar burst fracture p atients treated operatively and nonoperatively were investigated with respect to treatment complications, resumption of employment, and qual ity of life. Data were obtained from hospital records, radiographs, an d written questionnaires. Of 93 patients diagnosed with lumbar fractur e between January 1987 and December 1989, 22 met the criteria for stud y (12 operative, ten nonoperative). Exclusion was based on single-colu mn compression or chance fractures, neurologic compromise, and nontrau matic fractures. The patient groups had distinctly different fracture patterns based on degree of anterior column compression (ACC). Trends toward significant differences in kyphotic angulation and canal compro mise were noted. There were no preoperative complications. Varying mod es of external immobilization were used in both groups. One patient in each group used narcotic medications for pain at final follow-up eval uation. When comparing the operatively and nonoperatively treated lumb ar burst fracture patients in this study group, no significant differe nce in treatment outcome was established. Nonoperative treatment remai ns a viable alternative to operative intervention in selected lumbar b urst fracture patterns.