Surgical treatment of thoracolumbar fractures: fusion versus nonfusion

Purpose of the review Thoracolumbar spine fractures often result in prolonged hospitalization and significant disability. Yet, a variety of surgical treatment options are available for each specific injury, and the optimal technique is not always evident. The following review summarizes the recent advances in the surgical treatment of thoracolumbar spine fractures. Recent findings The first decision that a surgeon must make is whether surgical treatment is best. Recently, a new classification system has been developed, and validated, to aid in the decision of operative and nonoperative management. Choosing the best surgical procedure also can be quite challenging. Techniques gaining popularity in the past year include short segment fixation, surgical stabilization without fusion, and minimally invasive stabilization. Summary Recent advances in the surgical treatment of thoracolumbar fractures will allow the surgeon to more certainly predict which patients will benefit from surgical intervention and then effectively treat the injury with the least invasive and debilitating procedure. The benefit of nonfusion surgical treatment, though promising, is still unclear and requires further research.

[1]  Alan H. Daniels,et al.  Variability in Rates of Arthrodesis for Patients With Thoracolumbar Spine Fractures With and Without Associated Neurologic Injury , 2007, Spine.

[2]  Moe R. Lim,et al.  World Journal of Emergency Surgery Open Access Regional Variability in Use of a Novel Assessment of Thoracolumbar Spine Fractures: United States versus International Surgeons , 2022 .

[3]  J. Carrino,et al.  Interrater reliability of identifying indicators of posterior ligamentous complex disruption when plain films are indeterminate in thoracolumbar injuries , 2007, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[4]  C. Schizas,et al.  Percutaneous surgical treatment of chance fractures using cannulated pedicle screws. Report of two cases. , 2007, Journal of neurosurgery. Spine.

[5]  Andrew Mahar,et al.  Short-Segment Fixation of Lumbar Burst Fractures Using Pedicle Fixation at the Level of the Fracture , 2007, Spine.

[6]  Jean-Pierre Mobasser,et al.  Percutaneous Pedicle Screw Instrumentation for Temporary Internal Bracing of Nondisplaced Bony Chance Fractures , 2007, Journal of spinal disorders & techniques.

[7]  B. Aarabi,et al.  The Influence of Fracture Mechanism and Morphology on the Reliability and Validity of Two Novel Thoracolumbar Injury Classification Systems , 2007, Spine.

[8]  A. Y. Tabak,et al.  Treatment of unstable thoracolumbar junction burst fractures with short- or long-segment posterior fixation in magerl type a fractures , 2007, European Spine Journal.

[9]  M. Wild,et al.  Five-year follow-up examination after purely minimally invasive posterior stabilization of thoracolumbar fractures: a comparison of minimally invasive percutaneously and conventionally open treated patients , 2007, Archives of Orthopaedic and Trauma Surgery.

[10]  B. Qian,et al.  Effect of posterolateral fusion on thoracolumbar burst fractures. , 2006, Chinese journal of traumatology = Zhonghua chuang shang za zhi.

[11]  Shih-Tien Wang,et al.  Is Fusion Necessary for Surgically Treated Burst Fractures of the Thoracolumbar and Lumbar Spine?: A Prospective, Randomized Study , 2006, Spine.

[12]  M. Fehlings,et al.  Agreement Between Orthopedic Surgeons and Neurosurgeons Regarding a New Algorithm for the Treatment of Thoracolumbar Injuries: A Multicenter Reliability Study , 2006, Journal of spinal disorders & techniques.

[13]  R. Hurlbert,et al.  Validating a Newly Proposed Classification System for Thoracolumbar Spine Trauma: Looking to the Future of the Thoracolumbar Injury Classification and Severity Score , 2006, Journal of orthopaedic trauma.

[14]  J. Kirkpatrick,et al.  Short segment fixation of thoracolumbar burst fractures. , 2006, Orthopedics.

[15]  Thomas M. Reilly,et al.  Unstable Thoracolumbar Burst Fractures: Anterior-Only Versus Short-Segment Posterior Fixation , 2006, Journal of spinal disorders & techniques.

[16]  P. Korovessis,et al.  Combined Anterior Plus Posterior Stabilization Versus Posterior Short-Segment Instrumentation and Fusion for Mid-Lumbar (L2–L4) Burst Fractures , 2006, Spine.

[17]  A. Urzúa,et al.  Residual mobility of instrumented and non-fused segments in thoracolumbar spine fractures , 2006, European Spine Journal.

[18]  T. Takebayashi,et al.  Adjacent segment stenosis after lumbar fusion requiring second operation , 2005, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[19]  T. Matthews,et al.  Use of long rods and a short arthrodesis for burst fractures of the thoracolumbar spine. A long-term follow-up study. , 1994, The Journal of bone and joint surgery. American volume.