A major focus of our research group has been on the treatment of thoracolumbar burst fractures. Thoracolumbar burst fractures without neurological deficit result in a relatively stable injury because both the anterior and the middle columns of the spine fail under a compression load without associated distraction, shear, rotation, or translational injury. Treatment of the neurologically intact patient is controversial, but is generally non-surgical involving early mobilization in an adjustable thoracolumbosacral orthosis (TLSO). To determine whether a brace was necessary we conducted the first multicenter randomized controlled equivalence trial. This work demonstrated that treatment with a TLSO is equivalent to treatment using early ambulation without a brace at 2 years and 5-10 years post-injury with respect to patient-rated outcomes if a TLSO or body cast is not available.
A second focus of our research group is the optimal treatment for C2 fractures in the elderly. Elderly patients have a higher prevalence of cervical spine fractures, including C2 fractures in particular, than any other age group. Current efforts are aimed at describing the clinical, radiographic, and MRI outcomes in nonoperative type II odontoid fractures in the elderly.
Radovanovic I, Urquhart J, Rajoulinajad P, Gurr KR, Siddiqi F, Bailey CS. C2 fractures in the Elderly: A Review of fracture types, etiology, and mortality. Journal of Neurosurgery: Spine 27:494-500, November 2017.
Urquhart JC, Alrehaili OA, Fisher C, Fleming A, Rasoulinejad P, Gurr K, Bailey S, Siddiqi F, Bailey CS. Treatment of thoracolumbar burst fractures: extended follow-up of a randomized clinical trial comparing orthosis versus no orthosis. Journal of Neurosurgery Spine 27:42-47, July 2017.
Bailey CS, Urquhart JC, Dvorak MF, Nadeau M, Body M, Thomas K, Kwon BK, Gurr KR, Bailey SI, Fisher GF. Orthosis versus No Orthosis for the treatment of thoracolumbar burst fractures without neurologic injury: A multicenter prospective randomized trial. Spine J 14:2557-2564, November 2014.