# Fusion Versus Non-fusion for Thoracolumbar Burst Fractures Treated With Short-Segment Posterior Instrumentation Including the Fracture Level

## TL;DR

This study compares fusion and non-fusion surgeries for thoracolumbar burst fractures and finds similar outcomes with non-fusion offering additional benefits.

## Contribution

The study provides evidence that non-fusion surgery can be as effective as fusion for thoracolumbar burst fractures.

## Key findings

- No significant differences in radiological, functional, or neurological outcomes between fusion and non-fusion groups.
- Non-fusion surgery resulted in shorter operative time, less blood loss, and no donor site morbidity.
- Non-fusion preserved more motion segments without increasing complication rates.

## Abstract

Introduction

Thoracolumbar burst fractures are the most typical variant of injury to the spine. However, debate over the optimum treatment approach continues. Although spinal fusion has long been considered the gold standard in spinal fixation, the non-fusion procedure has recently gained prominence.

Objectives

To evaluate fusion versus non-fusion procedures in surgically treated thoracolumbar burst fractures.

Methods

This quasi-experimental study included 64 patients with single-level thoracolumbar fractures treated between July 2014 and June 2019. Patients were randomly allocated into two cohorts of 32 (50%) each based on registration numbers: those with odd numbers underwent fusion surgery (Group I), and those with even numbers underwent non-fusion surgery (Group II). All patients received short-segment posterior instrumentation, including the fractured vertebra. Radiological, functional, and neurological outcomes were assessed and contrasted. SPSS version 25.0 (IBM Corp., Armonk, NY) was used to conduct the statistical analysis.

Results

No statistically significant difference was observed between the two groups in terms of radiological outcomes, functional outcomes, neurological improvement, or implant failure rates. The non-fusion group, however, exhibited reduced operative duration and hemorrhage, absence of donor site morbidity, and preserved a greater number of motion segments. No notable intraoperative or postoperative complications were noted, nor were any substantial differences observed in either group.

Conclusion

Routine spinal fusion may be unnecessary for surgically repaired thoracolumbar burst fractures, as the non-fusion method provides similar outcomes with additional advantages.