Abstract
Thoracolumbar spine fractures are increasingly treated operatively. Advances in surgical
techniques, including minimal invasive procedures, the improvement of implants and
instruments, and better anaesthesiologic management have contributed to this development.
However evidence based guidelines to decide which spinal injuries benefit from operative
treatment are still lacking. Especially the treatment of burst fractures is still
controversial. A basic understanding of the pathophysiologic mechanisms, a good interpretation
of X-rays and CT, and a correct classification of these injuries are therefore important
factors in making a well-founded decision whether to operate or not. When operative
treatment is indicated one has to decide on the best approach, depending on the level
of the injury, the fracture type, narrowing of the spinal canal and/or neurological
symptoms, as well as the general condition of the patient and the experience of the
surgeon.
Key words
Thoracolumbar fracture - operative treatment - fracture classification - surgical
approach
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Dr. Fred C. Bakker
Department of Trauma Surgery · VU University Medical Center
P.O. Box 70 57
1007 MB Amsterdam
The Netherlands
Phone: +31/20/4 44 45 54
Fax: +31/20/4 44 02 74
Email: fc.bakker@vumc.nl