Surgery versus conservative management of stable thoracolumbar fracture: the PRESTO feasibility RCT (original) (raw)

Abstract

Background There is informal consensus that simple compression fractures of the body of the thoracolumbar vertebrae between the 10th thoracic vertebra and the second lumbar vertebra without neurological complications can be managed conservatively and that obvious unstable fractures require surgical fixation. However, there is a zone of uncertainty about whether surgical or conservative management is best for stable fractures. Objectives To assess the feasibility of a definitive randomised controlled trial comparing surgical fixation with initial conservative management of stable thoracolumbar fractures without spinal cord injury. Design External randomised feasibility study, qualitative study and national survey. Setting Three NHS hospitals. Methods A feasibility randomised controlled trial using block randomisation, stratified by centre and type of injury (high- or low-energy trauma) to allocate participants 1 : 1 to surgery or conservative treatment; a costing analysis; a national...

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  2. Professor Joy Adamson (https://orcid.org/0000-0002-9860-0850) (Mary Kinross Charitable Trust and Royal College of Surgeons Chairperson in Surgical Trials and Health Sciences) was a co-applicant who contributed to the design and analysis of the qualitative study, and contributed to and commented on all drafts of the report.
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