Study designProspective multicentric study.ObjectiveThoracolumbar fractures without neurologic deficit are challenging situations in terms of treatment decision making. We aimed to analyze the occurrence of adverse events (AEs) after surgical and nonsurgical treatment and its impact on functional outcomes.Methods198 patients from a prospective multicentric database were included. The occurrence of adverse events and treatment failure within 2 years of follow up were recorded. ODI was compared between patients with and without adverse events at six months, 1 year and 2 years follow up. Multivariable regression analysis was conducted to assess the association between post-treatment adverse events and ODI at 1-year follow-up.Results46 adverse events were recorded (23.2%). Higher categories of the Charlson Comorbidity Index (CCI) (P = 0.006), unemployment or retirement (P = 0.027), and current smoking (P = 0.008) were significantly associated with the occurrence of adverse events whereas no significant differences were observed in terms of treatment decision (conservative vs surgical). ODI values were significantly higher in patients with adverse events at the 6-month and 1-year follow-up visits without significant differences at 2 years follow up. Treatment failure was observed in only 5 patients.ConclusionWe found association between the occurrence of AE and higher ODI at 6-months and one-year follow up. Additionally, a higher CCI and smoking status were associated with higher likelihood to develop adverse events in our cohort.