Surgical Management of Thoracolumbar Fractures: Rationale for Short Fixation

Series of cases from our own practice as a means of reviewing the basic principles for the treatment of thoracolumbar fractures are presented in this article. Although there are no widely accepted evidence-based standards to guide surgeons in choosing treatment approaches, several basic and logical principles may be applied to each case to first decide whether a patient is best managed nonoperatively or with surgical treatment. If operative management is indicated, the surgeon must decide whether decompression and/or stabilization is indicated, whether surgery should be done from an anterior and/or posterior approach, the timing of surgery, the surgical technique, and how extensive the instrumentation should be. Through a series of case example, the authors emphasize the principles of short fixation for most cases to preserve spinal motion. Successful surgery for thoracolumbar fracture can be achieved for most cases with short anterior or posterior fixation.