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.
