Nonoperative management and treatment of spinal injuries.
METHODS
Review of literature.


OBJECTIVE
To delineate and discuss nonoperative treatment and treatment of spinal injuries.


BACKGROUND
Nonoperative methods have been a mainstay of care for spinal injuries since ancient Egypt. The vast majority of all spinal injuries should be treated in the nonoperative fashion. The indications and methods continue to evolve.


METHODS
A PubMed search of the literature returned more than 1000 articles related to spine trauma. A total of 270 were references to nonoperative treatment, and 100 were thought to be relevant and included in this review.


RESULTS
All spine injuries are treated in a nonoperative manner, at least initially. The vast majority of injuries are successfully and appropriately treated in a definitive manner with nonsurgical methods. Over the past 10-15 years, the advent of better rigid cervical fixation has decreased the use of halo vests as definitive treatment of many cervical injuries. In contrast, during the same time, more thoracolumbar injuries are being treated in a nonsurgical fashion because the outcomes have been shown to be similar or superior.


CONCLUSIONS
As with all of medicine, the treatment of spine trauma will continue to evolve with time. It is paramount that the physician selects the treatment that will provide the best short-term recovery with the least impact on long-term function.
Rechtine
Glenn R
GR
Department or Orthopaedics, University of Rochester Medical Center, Rochester, NY 14642, USA. GRechtine@aol.com