Treatment of thoracolumbar burst fractures / 中国矫形外科杂志

ABSTRACT

Thoracolumbar burst fractures account for more than half of all thoracolumbar fractures,which often result in neurologic deficit,kyphosis deformity and significant disability.The management of thoracolumbar burst fractures differ with the types.Nowadays,the accepted methods of treatment of thoracolumbar burst fractures include conservative therapy,posterior reduction and instrumentation,anterior decompression and instrumentation,combined anterior-posterior approach and minimally invasive approach.Howerer,the optimal technique is not always evident.There is no precise classification system to determine which surgical procedure is the best.The following review summarizes the recent advances in treatment of thoracolumbar burst fractures.Recent clinical evidence shows that there is no significant difference between conservative therapy and surgical treatment for thoracolumbar burst fractures without neurologic deficit,and that surgical treatment should be considered for unstable fractures with neurological injuries.Some other clinical evidence shows that short segment combined fractured vertebra plasty with various manners has gained popularity,because it can reconstruct anterior column and decrease the failure of internal fixation and the occurrence of long-term spinal kyphosis deformity.In accordance with the principles of biomechanics and taking into account the occurrence of degeneration of adjacent segment,surgeons gradually applied non-fusion technology in clinical practice,and yet its long-term results need to be confirmed by further studies.