Thomas Kenneth C, Bailey Christopher S, Dvorak Marcel F, Kwon Brian, Fisher Charles
Vancouver Hospital and Health Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada.
J Neurosurg Spine. 2006 May;4(5):351-8. doi: 10.3171/spi.2006.4.5.351.
Despite extensive published research on thoracolumbar burst fractures, controversy still surrounds which is the most appropriate treatment. The objective of this study was to evaluate the scientific literature on operative and nonoperative treatment of patients with thoracolumbar burst fractures and no neurological deficit.
In their search of the literature, the authors identified all possible relevant studies concerning thoracolumbar burst fracture without neurological deficit. Two independent observers performed study selection, methodological quality assessment, and data extraction in a blinded and objective manner for all papers identified during the search. In a synthesis of the literature, the authors obtained evidence for both operative and nonoperative treatments.
There is a lack of evidence demonstrating the superiority of one approach over the other as measured using generic and disease-specific health-related quality of life scales. There is no scientific evidence linking posttraumatic kyphosis to clinical outcomes. The authors found that there is a strong need for improved clinical research methodology to be applied to this patient population.
尽管已有大量关于胸腰椎爆裂骨折的研究发表，但对于哪种治疗方法最为合适仍存在争议。本研究的目的是评估有关无神经功能缺损的胸腰椎爆裂骨折患者手术及非手术治疗的科学文献。
在文献检索过程中，作者识别出所有可能与无神经功能缺损的胸腰椎爆裂骨折相关的研究。两名独立观察者以盲法和客观的方式对检索过程中识别出的所有论文进行研究选择、方法学质量评估及数据提取。在文献综合分析中，作者获取了手术及非手术治疗的证据。
缺乏证据表明，使用通用的和疾病特异性的健康相关生活质量量表衡量时，一种治疗方法优于另一种。没有科学证据将创伤后后凸畸形与临床结果联系起来。作者发现，迫切需要将改进的临床研究方法应用于这一患者群体。
