Rational treatment planning entails systematically working through specific criteria pertaining to diagnosis, classification, indication, and therapy of thoracolumbar spinal injuries on the basis of experimental and clinical findings. All treatments should, of course, aim to restore the shape of the spine and to remove potential instabilities in advance. Surgery must enable early rehabilitation, particularly in the case of complete paraplegia, in order to prevent potential complications associated with this type of injury. The treatment indicated for stable fractures, where no further changes to the shape of the spine are expected if functional treatment is applied, is conservative, functional treatment. If surgical treatment is indicated, posterior stabilisation with a transpedicular anchored internal fixation system, by means of which the patient can be mobilised immediately, is preferred at present. The anterior column should be reconstructed by using minimally-invasive procedures and load bearing implants.
1
Aebi M, Etter C, Kehl T, Thalgott J.
Stabilization of the lower thoracic and lumbar spine with the internal spinal skeletal fixation system. Indications, techniques, and first results of treatment.
Spine.
1987;
12
544-551
3
An H S, Vaccaro A, Cotler J M, Lin S.
Low lumbar burst fractures, comparison among body cast, Harrington rod, Luque rod, and Steffee plate.
Spine.
1991;
16
440-444
4
Andreychik D A, Alander D H, Senica K M, Stauffer E S.
Burst fractures of the second through fifth lumbar vertebrae.
J Bone Joint Surg [Am].
1996;
78
1156-1166
6
Beisse R, Potulksi M, Bühren V.
Thorakoskopisch gesteuerte ventrale Plattenspondylodese bei Frakturen der Brust- und Lendenwirbelsäule.
Operat Orthop Traumatol.
1999;
11
54-59
7 Blauth M, Knop C, Bastian L. Brust- und Lendenwirbelsäule. In: Tscherne H, Blauth M. Tscherne Unfallchirurgie - Wirbelsäule. Springer, Berlin, Heidelberg, New York 1998; A241-A372
8
Boerger T O, Limb D, Dickson R A.
Does “canal clearance” affect neurological outcome after thoracolumbar burst fractures?.
J Bone Joint Surg [Br].
2000;
82
629-635
9
Daniaux H.
Transpedikuläre Reposition und Spongiosaplastik bei Wirbelkörperbrüchen der unteren Brust- und Lendenwirbelsäule. Indikation, Behandlungsregime, Ergebnisse.
Chirurg.
1991;
62
404-408
10
Garfin S R, Yuan H A, Reiley M A.
New technologics in spine. Kyphosplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures.
Spine.
2001;
26
1511-1515
11
Gurwitz G S, Dawson J, McNamara M J, Federspiel C F, Spengler D M.
Biomechanical analysis of three surgical approaches for lumbar burst fractures using short segment instrumentation.
Spine.
1993;
18
977-982
12
Jutte P C, Castelein R M.
Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations.
Eur Spine J.
2002;
11
594-598
14
Knop C, Blauth M, Bühren V, Hax P -M, Kinzl L, Mutschler W, Pommer A, Ulrich C, Wagner S, Weckbach A, Wentzensen A, Wörsdörfer O.
Operative Behandlung von Verletzungen des thorakolumbalen Übergangs - Teil 1: Epidemiologie.
Unfallchirurg.
1999;
102
924-935
15
Knop C, Blauth M, Bühren V, Hax P -M, Kinzl L, Mutschler W, Pommer A, Ulrich C, Wagner S, Weckbach A, Wentzensen A, Wörsdörfer O.
Operative Behandlung von Verletzungen des thorakolumbalen Übergangs - Teil 2: Operation und röntgenologische Befunde.
Unfallchirurg.
2000;
103
1032-1047
16
Knop C, Blauth M, Bühren V, Arand M, Egbers H J, Hax P -M, Oestern H -J, Pizanis A, Roth R, Nothwang J, Weckbach A, Wentzensen A.
Operative Behandlung von Verletzungen des thorakolumbalen Übergangs - Teil 3: Nachuntersuchung.
Unfallchirurg.
2001;
104
583-600
17
Knop C, Lange U, Bastian L, Oeser M, Blauth M.
Biomechanical compression tests with a new implant for thoracolumbar vertebral body replacement.
Eur Spine J.
2001;
10
30
18 Knop C, Blauth M. Verletzungen der Brust- und Lendenwirbelsäule ohne und mit neurologischer Beteiligung. In: OP-Journal 2001, 17, Thieme Verlag, Stuttgart, New York 2001; 102-111
19
Laine T, Lund T, Ylikoski M, Lokikoski J, Schlenzka D.
Accuracy of pedicle screw insertion with and without computer assistance: a randomized controlled clinical study in 100 consecutive patients.
Eur Spine J.
2000;
9
235-240
22
Mann K A, McGowan D P, Fredrickson B E, Falahee M, Yuan H A.
A biomechanical investigation of short segment spinal fixation for burst fractures with varying degrees of posterior disruption.
Spine.
1990;
15
470-478
23
Mirza S K, Mirza A J, Chapman J R, Andersen P A.
Classifications of thoracic and lumbar fractures: Rationale and supporting data.
J Am Acad Orthop Surg.
2002;
10
364-377
24
Mumford J, Weinstein J N, Spratt K F, Goel V K.
Thoracolumbar burst fractures. The clinical efficacy and outcome of nonoperative management.
Spine.
1993;
18
955-970
26
Resch H, Rabl M, Klampfer H, Ritter E, Povacz P.
Operative vs. konservative Behandlung von Frakturen des thorakolumbalen Übergangs.
Unfallchirurg.
2000;
103
281-288
28
Ward P, Harvey A R, Ramos J, Carvell J E, Grundy D J.
Hartshill rectangle: failure of spinal stabilisation in acute spinal cord injury.
Eur Spine J.
2000;
9
152-155
30 White A A, Panjabi M M. Clinical biomechanics of the spine. Lippincott, Philadelphia 1990; 278
31
Whitehill R, Stowers S F, Fechner R E. et al .
Posterior cervical fusions using cerclage wires, methacrylate cement and autogenous bone graft. An experimental study of a canine model.
Spine.
1987;
12
12-22
33
Wilke H -J, Kemmerich V, Claes L E, Arand M.
Combined anteroposterior spinal fixation provides superior stabilisation to a simple anterior or posterior procedure.
J Bone Joint Surg [Br].
2000;
83
609-617
34
Wörsdörfer O, Ulrich C, Claes L.
Comparative biomechanics evaluation of distraction rod-system and various transpedicular fixation devices. Orthop Transactions.
J Bone Joint Surg [Am].
1989;
13
118-119
