Seminars in Spine Surgery
Volume 22, Issue 1 , Pages 20-32, March 2010

Surgical Management of Thoracolumbar Fractures: Rationale for Short Fixation

  • Justin S. Smith, MD, PhD

      Affiliations

    • Department of Neurosurgery, University of Virginia, Charlottesville, VA
  • ,
  • Vincent Arlet, MD

      Affiliations

    • Department of Neurosurgery, University of Virginia, Charlottesville, VA
    • Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA
    • Corresponding Author InformationAddress reprint requests to Vincent Arlet, MD, Division of Scoliosis and Spine Surgery, Department of Orthopedic Surgery, University of Virginia, 400 Ray C. Hunt Drive, Suite 330, Charlottesville, VA 22903

published online 04 January 2010.

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.

Keywords: spine, thoracolumbar fracture burst

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PII: S1040-7383(09)00081-1

doi:10.1053/j.semss.2009.10.004

Seminars in Spine Surgery
Volume 22, Issue 1 , Pages 20-32, March 2010