Chang Victor, Holly Langston T
Departments of Neurosurgery and.
Neurosurg Focus. 2014;37(1):E3. doi: 10.3171/2014.4.FOCUS1477.
Traumatic fractures of the thoracolumbar spine are relatively common occurrences that can be a source of pain and disability. Similarly, osteoporotic vertebral fractures are also frequent events and represent a significant health issue specific to the elderly. Neurologically intact patients with traumatic thoracolumbar fractures can commonly be treated nonoperatively with bracing. Nonoperative treatment is not suitable for patients with neurological deficits or highly unstable fractures. The role of operative versus nonoperative treatment of burst fractures is controversial, with high-quality evidence supporting both options. Osteoporotic vertebral fractures can be managed with bracing or vertebral augmentation in most cases. There is, however, a lack of high-quality evidence comparing operative versus nonoperative fractures in this population. Bracing is a low-risk, cost-effective method to treat certain thoracolumbar fractures and offers efficacy equivalent to that of surgical management in many cases. The evidence for bracing of osteoporotic-type fractures is less clear, and further investigation will be necessary to delineate its optimal role.
胸腰椎创伤性骨折是相对常见的情况，可能导致疼痛和残疾。同样，骨质疏松性椎体骨折也很常见，是老年人特有的重大健康问题。神经功能完好的胸腰椎创伤性骨折患者通常可通过支具进行非手术治疗。非手术治疗不适用于有神经功能缺损或高度不稳定骨折的患者。爆裂骨折手术治疗与非手术治疗的作用存在争议，高质量证据支持这两种选择。在大多数情况下，骨质疏松性椎体骨折可通过支具或椎体强化治疗。然而，在这一人群中，比较手术与非手术治疗骨折的高质量证据不足。支具是治疗某些胸腰椎骨折的低风险、成本效益高的方法，在许多情况下其疗效与手术治疗相当。对于骨质疏松型骨折使用支具的证据尚不清楚，需要进一步研究以明确其最佳作用。
