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

OBJECTIVE

The management of thoracolumbar compression fractures in nonosteoporotic patients remains controversial. This study compared the time to return to work between kyphoplasty and conservative treatment (bracing) in professionally active adults sustaining thoracolumbar compression fractures.

METHODS

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 Classification System type A fractures from T3 to L5, without neurological deficit, and 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. The mean follow-up was 2 years.

RESULTS

Forty-five patients underwent kyphoplasty, and 81 received conservative treatment in the final analysis. The median time to return to work was significantly shorter in the kyphoplasty group (6.5 weeks [interquartile range: 4-9]) than that in the bracing group (13 weeks [interquartile range: 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.

CONCLUSIONS

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.