Return to Work After Kyphoplasty Versus Bracing for Traumatic Thoracolumbar Fractures: A Retrospective Comparative Study.

Abstract

Management of thoracolumbar compression fractures in non-osteoporotic patients remains controversial. This study compared time to return to work between kyphoplasty and conservative treatment (bracing) in professionally active adults sustaining thoracolumbar compression fractures. We conducted a retrospective single-center study at a French university hospital between January 2017 and August 2020. Patients aged 18-60 years with AO Spine type A fractures from T3 to L5, without neurological deficit, treated with either kyphoplasty or bracing were included. Sociodemographic and occupational characteristics were recorded. Clinical outcomes included pain intensity (Numerical Rating Scale), disability (Oswestry Disability Index), and patient satisfaction. Work-related outcomes were Median time to return to work and permanent work disability. Return to sports activity was also assessed. Mean follow-up was 2 years. 45 patients underwent kyphoplasty and 81 received conservative treatment in final analysis. Median time to return to work was significantly shorter in the kyphoplasty group (6.5 weeks [IQR: 4-9]) than in the bracing group (13 weeks [IQR: 12-17]). Residual pain scores and disability levels were statistically significantly lower in the kyphoplasty group. High satisfaction was reported by 75.5% of patients after kyphoplasty compared with 27.1% after bracing. No major complications were observed. Kyphoplasty was associated with a shorter time to return to work than conservative management facilitating a more rapid return to professional activity compared with conservative management.