In a Prospective multicentre cohort study Dvorak et al. from the University of British Columbia ( – Vancouver), Univ. Medical Center Utrecht, Malteser Waldrankenhaus St. Marien (Erlangen), Univ. of Washington (Seattle), etc. published in the Global Spine Journal to examine whether surgical vs non‑surgical treatment accelerates clinically meaningful improvement (MCID of 12.8 points ODI) in neurologically intact thoracolumbar burst fracture patients within 1 year. Similar median time to reach MCID in both groups (~25 days). Post‑hoc suggests surgery may achieve ‘minimal disability’ (ODI <20) faster (69 vs 82 days; P=0.057). Larger trials needed 2)
Critical Appraisal
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Strengths: Prospective design, multicentre/international inclusion enhances generalizability; uses accepted ODI threshold.
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Limitations: Not randomized—treatment selection bias possible; statistical power limited—non-significant trend (P=0.057) may be false negative; outcome centered on ODI improvement, lacking radiographic, complication, or cost analysis within this paper.