Spine fracture study to reveal hidden degeneration risks

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: Conservative Treatment Cohort: * Age 18 to 50 years. * Acute or subacute traumatic fracture of the thoracolumbar junction at the start of treatment. * AOSpine type A2, A3, or A4 fracture. * No clinical evidence of nerve root or spinal cord compression at the injured level. * Conservative treatment of the thoracolumbar junction fracture. * Minimum follow-up period of 1 year. * Written informed consent for prospective follow-up or additional study procedures, when applicable. Surgical Treatment Cohort: * Age 18 to 50 years. * Acute or subacute traumatic fracture of the thoracolumbar junction at the start of treatment. * AOSpine type A2, A3, or A4 fracture. * No clinical evidence of nerve root or spinal cord compression at the injured level. * Surgical treatment performed without disruption of the posterior supporting column. * Surgical treatment may include anterior fusion, transpedicular fixation, or combined surgery without direct posterior decompression. * Minimum follow-up period of 1 year. * Written informed consent for prospective follow-up or additional study procedures, when applicable. Control Cohort: * Age 18 to 50 years. * At least two computed tomography examinations covering the Th9-L4 vertebral levels. * Interval of at least 1 year between computed tomography examinations. * Computed tomography performed for reasons unrelated to traumatic or degenerative thoracolumbar junction disease. * No imaging artifacts at the spinal levels included in the study assessment. Exclusion Criteria: Conservative Treatment Cohort: * Severe combined trauma. * Severe concomitant disease. * Systemic bone or joint disease associated with changes in facet joints or intervertebral discs, including diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, rheumatoid arthritis, or similar disorders. * Verified osteoporosis. * Bone density of thoracolumbar vertebrae less than 100 Hounsfield units. * Previous spine surgery. * American Society of Anesthesiologists physical status class 4 or 5. * Participation in another clinical study related to treatment of spinal disease or spinal trauma. * Withdrawal of informed consent, when applicable. Surgical Treatment Cohort: * Severe combined trauma. * Severe concomitant disease. * Systemic bone or joint disease associated with changes in facet joints or intervertebral discs, including diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, rheumatoid arthritis, or similar disorders. * Verified osteoporosis. * Bone density of thoracolumbar vertebrae less than 100 Hounsfield units. * Previous spine surgery. * Direct posterior decompression or other surgery disrupting the posterior supporting column. * American Society of Anesthesiologists physical status class 4 or 5. * Participation in another clinical study related to treatment of spinal disease or spinal trauma. * Withdrawal of informed consent, when applicable. Control Cohort: * Complicated fracture of any spinal region. * Combined trauma or severe concomitant disease limiting patient mobility. * Systemic bone or joint disease associated with changes in facet joints or intervertebral discs, including diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, rheumatoid arthritis, or similar disorders. * Grade 4 facet joint degeneration according to the Pathria classification at the studied levels. * Bone density of thoracolumbar vertebrae less than 100 Hounsfield units. * Previous spine surgery, including surgery without implants. * Spinal fracture with injury to the posterior supporting column. * Participation in another clinical study related to treatment of spinal disease or spinal trauma.