Overview

Fractures of the thoracic and lumbar spine account for nearly 90% of all spinal fractures. Thoracolumbar fractures usually result from high-energy trauma, most commonly falls from height or road traffic accidents. These injuries typically produce vertical compression of a slightly flexed spine, although rotational, shear, and extension forces may also lead to different fracture patterns. In addition to being a significant cause of morbidity and mortality, neurological impairment is associated with approximately 20% of these injuries. Most patients with thoracolumbar fractures belong to the active and productive age group. Over the past few decades, considerable advances have been made in intraoperative monitoring, diagnostic imaging, and the development of more stable fixation devices. In addition, the use of steroids to reduce secondary injury to the central nervous system has received substantial attention. Despite these advances, the management of thoracolumbar fractures continues to present challenges for orthopedic surgeons. Several surgical treatment options have been developed for thoracolumbar burst fractures, including short- or long-segment posterior pedicle screw fixation, direct anterior decompression through corpectomy, and combined anterior-posterior spinal approaches.

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