Thoracolumbar Spine Trauma: II. Principles of Management.
The care of patients with thoracolumbar spine trauma with or without neurologic deficits has evolved dramatically over the past 20 years with the emergence of tertiary-care spinal injury centers and the development of more effective spinal instrumentation and anesthesia techniques. Despite these advances, the majority of patients with thoracolumbar injuries are still treated nonoperatively with cast or brace immobilization and early ambulation. More aggressive treatment is guided by the use of classification systems that detail the mechanism of injury, the degree of compromise of spinal structures, and the potential for late mechanical instability or neural injury. The goal of treatment remains attainment of spinal stability with protection or improvement of the patient's neurologic status, allowing rapid and maximal functional recovery.
Spivak
JM
Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York; New York University School of Medicine, New York.
Vaccaro
AR
Cotler
JM