*4.2. Comparison with Previous Studies*

Kweh et al. published a systematic review and meta-analysis addressing a similar topic [65]. This study eventually included 13 articles for qualitative synthesis and six studies for quantitative synthesis. They found no statistically significant difference in sagittal correction loss between implant retention and removal cohorts, and suggested significantly improved pain intensity and ODI scores. They concluded that planned implant removal results in superior functional outcomes without significant differences in kyphotic angle correction loss compared to implant retention in younger patients with thoracolumbar burst fractures who undergo posterior surgical stabilization. In comparison, we included more types of studies to fully elaborate on this clinical dilemma. Although we did not perform a meta-analysis mainly due to the significant clinical heterogeneity among studies, we found similar benefits but also highlighted the potential risks. We further revealed conflicting evidence regarding the management of thoracolumbar burst fractures.
