{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:56:03Z","timestamp":1791982563905,"version":"4.4.0"},"reference-count":8,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"AO Spine through the AO Spine Knowledge Forum Trauma"},{"name":"Provided Directly Through AO Network Clinical Research"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross-sectional survey study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate factors affecting decision-making in thoracolumbar burst-fractures without neurologic deficit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 40-question survey addressing expert-related, economic, and radiological factors was distributed to 30 international trauma experts. Descriptive statistics were used to assess the impact of these factors on operative or non-operative management preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 30 experts, 27 completed the survey. The majority of respondents worked at level 1 trauma centers (81.5%) within university settings (77.8%). They were primarily orthopedic surgeons (66.7%) and had over 10\u00a0years of experience (70.4%). About 81% found distinguishing between A3 and A4 fractures relevant for decision-making. Most experts (59%) treated A3 fractures non-surgically, while only 30% treated A4 fractures conservatively. Compensation systems did not influence treatment recommendations, and hospital measures promoting surgeries did not significantly affect distribution. Radiological factors, such as local kyphosis (25\/27), fracture comminution (23\/27), overall sagittal balance (21\/27), and spinal canal narrowing (20\/27), influenced decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incomplete burst fractures (A3) are predominantly treated non-surgically, while complete burst fractures (A4) are primarily treated surgically. Compensation, third-party incentives, and outpatient care did not significantly impact decision-making. Radiological factors beyond the AO Spine thoracolumbar classification system seem to be essential and warrant further evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231211286","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T13:31:50Z","timestamp":1707312710000},"page":"62S-65S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["What Factors Influence Surgeons in Decision-Making in Thoracolumbar Burst Fractures? A Survey-Based Investigation of a Panel of Spine Surgery Experts"],"prefix":"10.1177","volume":"14","author":[{"given":"Klaus J.","family":"Schnake","sequence":"first","affiliation":[{"name":"Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien Erlangen, Erlangen, Germany"},{"name":"Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel F.","family":"Dvorak","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cumhur F.","family":"\u00d6ner","sequence":"additional","affiliation":[{"name":"University Medical Centers, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4520-6454","authenticated-orcid":false,"given":"Charlotte","family":"Dandurand","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Muijs","sequence":"additional","affiliation":[{"name":"University Medical Centers, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4649-0610","authenticated-orcid":false,"given":"Sebastian F.","family":"Bigdon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"bibr1-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.12.007"},{"key":"bibr2-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-03147-9"},{"key":"bibr3-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1186\/s13102-022-00468-4"},{"key":"bibr4-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005079.pub3"},{"key":"bibr5-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-2157-7"},{"key":"bibr6-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003295"},{"key":"bibr7-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182a8a381"},{"key":"bibr8-21925682231211286","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000824"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682231211286","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682231211286","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682231211286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:16:10Z","timestamp":1777446970000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682231211286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":8,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1177\/21925682231211286"],"URL":"https:\/\/doi.org\/10.1177\/21925682231211286","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}