Surgical treatment of thoracolumbar fractures

Spinal injuries are categorized into compression (type A), flexion-distraction (type B) and rotation (type C) injuries, which can be further divided into subtypes. Unenhanced images of the chest and lumbar spine in two planes are the initial standard diagnostic work-up. For more exact classification and evaluation computer tomography, and in some cases also magnetic resonance imaging, are required. Spinal injuries with neurological deficit and an open fracture are mandatory indications for immediate surgical intervention. All B and C injuries require prompt surgical stabilization. Spinal canal narrowing height loss of >= 50%, an overall malalignment of >25 degrees or >20 degrees malalignment in one plane are indications for surgery. Dorsoventral fusion is generally the desired method of choice for surgical treatment. Thoracoscopic as well as other minimally invasive surgical procedures are considered standard in thoracolumbar fractures.