{
  "abstract": "Introduction\n\nManagement of neurologically intact AO Spine A3 fractures remains variable, and multicenter data on treatment patterns and conversion to surgery are limited.Research question\n\nWhich patient-, injury-, and center-related factors are associated with initial operative treatment and secondary conversion after initial non-operative management?Material and methods\n\nThis retrospective multicenter study included adults with neurologically intact A3 fractures from T11 to L2 treated at nine German Level 1 trauma centers between 2018 and 2022. Mixed-effects logistic regression with center as a random intercept evaluated factors associated with initial operative treatment and secondary conversion.Results\n\nAmong 982 patients with 1007 fractures, 486 (49.5%) were initially managed non-operatively and 496 (50.5%) operatively. Age group was associated with initial operative treatment (global P < .001), whereas sex, fracture level, additional spinal injury, adjacent fracture, and mobility-restricting injury were not. Initial operative treatment ranged from 37.8% to 65.0% across centers. Secondary conversion occurred in 66 of 486 initially non-operatively managed patients (13.6%; 95% confidence interval 10.7-17.0%); 58 were clinically documented and 8 were identified solely by timing. None of the examined characteristics was independently associated with conversion. Between-center variation was greater for conversion (intraclass correlation coefficient 0.16; median odds ratio 2.13) than for initial operative treatment (intraclass correlation coefficient 0.05; median odds ratio 1.49).Conclusion\n\nInitial operative and non-operative strategies were used equally often, although treatment patterns varied across centers. Age was associated with initial treatment allocation, but measured patient- and injury-related characteristics did not explain the 13.6% secondary conversion rate after initial non-operative management.",
  "abstract_shown": true,
  "affiliations": [
    "BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, Ludwigshafen, 67071, Germany.",
    "Center for Spinal Surgery and Spinal Cord Injury, BG Kliniken Ludwigshafen und Tübingen gGmbH, BG Klinik Tübingen, Tübingen, 72076, Germany.",
    "BG Klinikum Duisburg gGmbH, Duisburg, 47249, Germany.",
    "Center for Spinal Surgery, BG Klinikum Murnau gGmbH, Murnau am Staffelsee, 82418, Germany.",
    "BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, 12683, Germany.",
    "Center for Spinal Surgery and Neurosurgery, BG Unfallklinik Frankfurt am Main gGmbH, Frankfurt am Main, 60389, Germany.",
    "Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil gGmbH, Ruhr-Universität Bochum, Bochum, 44789, Germany.",
    "Spine Center, BG Klinikum Hamburg gGmbH, Hamburg, 21033, Germany.",
    "BG Klinikum Bergmannstrost Halle gGmbH, 06112 Halle, Germany and University Medicine Halle, Halle, 06120, Germany."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Eric Mandelka",
      "orcid": "0000-0002-7337-2783"
    },
    {
      "affs": [
        0
      ],
      "name": "Mikel Schmelzle Elorriaga"
    },
    {
      "affs": [
        1
      ],
      "name": "Andreas Badke"
    },
    {
      "affs": [
        2
      ],
      "name": "Sandra Buchmann"
    },
    {
      "affs": [
        3
      ],
      "name": "Stefan Hauck"
    },
    {
      "affs": [
        4
      ],
      "name": "Peter Heumann"
    },
    {
      "affs": [
        5
      ],
      "name": "Frank Kandziora"
    },
    {
      "affs": [
        6
      ],
      "name": "Christiane Kruppa"
    },
    {
      "affs": [
        7
      ],
      "name": "Sebastian Krüger"
    },
    {
      "affs": [
        8
      ],
      "name": "Bernhard W Ullrich"
    },
    {
      "affs": [
        0
      ],
      "name": "Sven Y Vetter"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cqq34q1n8z8e6.bib",
  "cited_by": 0,
  "doi": "10.1016/j.bas.2026.107472",
  "fulltext_url": "https://europepmc.org/articles/PMC13693099",
  "id": "cqq34q1n8z8e6",
  "issns": [
    "2772-5294"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921397",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Spinal Fractures and Fixation Techniques"
    ]
  ],
  "openalex": "W7221667271",
  "pdf_url": "https://europepmc.org/articles/PMC13693099?pdf=render",
  "pmcid": "PMC13693099",
  "pmid": "42921397",
  "published": "2026-10-13",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cqq34q1n8z8e6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921397",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921397"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Spinal Fractures and Fixation Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Patient characteristics, fracture distribution and management patterns of incomplete thoracolumbar burst fractures: Results from a retrospective multicenter cohort of 982 patients.",
  "title_text": "Patient characteristics, fracture distribution and management patterns of incomplete thoracolumbar burst fractures: Results from a retrospective multicenter cohort of 982 patients.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/cqq34q1n8z8e6",
  "venue": "Brain & spine",
  "versions": []
}