Return to work following traumatic fractures of the thoracolumbar spine without spinal cord injury: a scoping review

BACKGROUND AND PURPOSE: Traumatic fractures of the thoracolumbar spine happen in the younger, working-age population and often compromise return to work (RTW), a key factor in functional recovery and overall quality of life. Our review summarizes the current evidence on RTW following traumatic thoracolumbar fractures without spinal cord injury. METHODS: A comprehensive literature search was conducted in Embase, Medline (OvidSP), Web of Science, CINAHL and Cochrane through July 2025. Studies were included if they met the following criteria: (i) traumatic thoracolumbar spine fracture without spinal cord injury, (ii) RTW reported as an outcome measure, (iii) prospective or retrospective cohort study or case-control design, and (iv) availability of a full-text article. Risk of bias was assessed for each included study. RESULTS: 31 studies met the inclusion criteria. Follow-up ranged from 3 to 226 months. Only 8 out of 31 studies were rated as low risk of bias. Reported RTW rates varied widely: 25% to 100% after surgical treatment (n = 19 studies) and 38% to 100% after non-surgical treatment (n = 19 studies). Pooled estimates showed that the mean RTW is between 76% and 84% in patients with a thoracolumbar spine fracture, irrespective of treatment modality. CONCLUSION: Estimated RTW rates range between 76% and 84%.