Long-term functional outcome after type A3 spinal fractures: operative versus non-operative treatment

The authors retrospectively studied, by questionnaires, the long-term (5 years) functional outcome after operative (posterior instrumentation : 38 cases) and non-operative treatment (25 cases) for type A3 spinal fractures (Comprehensive Classification) without neurological deficit. A possible bias of this study was the fact that the operative group included 60% A3.2 and A3.3 fractures, versus only 12% in the non-operative group. Two disease-specific questionnaires were used : the Visual Analogue Scale Spine Score and the Roland-Morris Disability Questionnaire. At follow-up the mean VAS scores were 82.6 and 80.8 in the operatively and non-operatively treated group, respectively; the difference was not significant. The mean RMDQ scores were 3.3 and 3.1 in the operatively and non-operatively treated groups, respectively; again the difference was not significant. Functional outcome appeared to be equally good five years after operative or non-operative treatment of type A3 "burst" fractures.