Options for burst fractures (Figure 4) without neurological injury include bed rest, immobilization with bracing treatment, and surgery with or without decompression. For burst fractures with less than 35° of kyphosis and without PLC involvement, early ambulation provides superior pain relief and improved functional outcomes at one-year follow-up. Conversely, burst fractures with PLC involvement are unstable and require surgical management. PLC compromise should be suspected in patients with vertebral compression >50%, angulation >25°, neurologic deficits, and positive MRI findings.