Implementation of a thoracolumbar compression fracture remote review protocol safely reduces in-person spine consultations.
TL;DR
Implementation of a remote review protocol for low-risk acute TLCF appears safe with similar outcomes and time to discharge compared to traditional bedside consultation.
Abstract
Background
Thoracolumbar compression fractures (TLCF) are often managed non-operatively with Thoracic-Lumbar-Sacral Orthosis (TLSO) bracing. This study evaluated the safety of a novel remote review protocol for non-operative TLCF management.
Methods
A single-center retrospective analysis was performed on adult trauma patients with acute TLCF. The PRE cohort (5/2022-4/2023) received formal bedside consultation, while the POST cohort (6/2023-6/2024) underwent remote review by an on-call spine surgery resident. The primary outcome was the incidence of TLCF-related complications.
Results
Of 120 patients, 79 (65.8%) were in the POST cohort. Demographics, injury mechanisms, vitals, and injury severity score were comparable between cohorts (all p > 0.05). Median time to discharge (PRE 28 h vs. POST 26 h, p = 0.61) was similar. No patients developed TLCF-related complications including neurological deficits or TLSO brace-related complications in either group.
Conclusions
Implementation of a remote review protocol for low-risk acute TLCF appears safe with similar outcomes and time to discharge compared to traditional bedside consultation. LEVEL OF EVIDENCE Level III.