Houston Methodist. Leading Medicine

Upper Spine FAQ

Question:

Is it possible to have a burst fracture of the spine and NOT have surgery? I find this hard to understand for someone like my mother who is in quite a bit of pain from this type of problem.

Answer:

It is possible these days to evaluate each patient for severity and stability (or instability) of spinal fractures. A special tool called the Thoracolumbar Injury Classification and Severity (TLICS) System. The TLICS guides the surgeon in making the best decision for each individual patient. It takes into consideration 1) the type of fracture you have and 2) any neurologic problems present as a result of the fracture. The TLICS also takes into account 3) whether or not the ligaments supporting the spine are damaged leaving the spine unstable. Not all burst fractures require surgical treatment. Some can be treated with conservative (nonoperative) care. The question is: who needs surgery and who doesn't? Are there ways to predict the most optimal treatment? The score given to each patient assigns a value from zero to three for each of the three categories mentioned. A total score of three or less suggests conservative care without surgery is possible. Patients with a score of five will need surgery. Anyone with a four falls in a gray zone that requires careful consideration of all the individual patient factors. Surgeon experience, judgment, and expertise are required for these "inbetween" cases. James W. Woodahl, Jr, MD, PhD, and Robert A. McGuire. Evidence for the Treatment of Thoracolumbar Burst Fractures. In Current Orthopaedic Practice. May/June 2012. Vol. 23. No. 3. Pp. 188-192.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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