• Craig H Rabb, Daniel J Hoh, Paul A Anderson, Paul M Arnold, John H Chi, Andrew T Dailey, Sanjay S Dhall, Kurt M Eichholz, James S Harrop, Sheeraz Qureshi, P B Raksin, Michael G Kaiser, and John E O'Toole.
• Department of Neurosurgery, University of Utah, Salt Lake City, Utah.
• Neurosurgery. 2019 Jan 1; 84 (1): E50-E52.

Question 1Does the surgical treatment of burst fractures of the thoracic and lumbar spine improve clinical outcomes compared to nonoperative treatment?Recommendation 1There is conflicting evidence to recommend for or against the use of surgical intervention to improve clinical outcomes in patients with thoracolumbar burst fracture who are neurologically intact. Therefore, it is recommended that the discretion of the treating provider be used to determine if the presenting thoracic or lumbar burst fracture in the neurologically intact patient warrants surgical intervention. Strength of Recommendation: Grade Insufficient.Question 2Does the surgical treatment of nonburst fractures of the thoracic and lumbar spine improve clinical outcomes compared to nonoperative treatment?Recommendation 2There is insufficient evidence to recommend for or against the use of surgical intervention for nonburst thoracic or lumbar fractures. It is recommended that the decision to pursue surgery for such fractures be at the discretion of the treating physician. Strength of Recommendation: Grade Insufficient The full version of the guideline can be reviewed at: https://www.cns.org/guideline-chapters/congress-neurological-surgeons-systematic-review-evidence-based-guidelines/chapter_1.

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