title: Surgical treatment of thoracolumbar fractures.
abstract: Surgical management of a thoracolumbar fracture varies according to many factors. Fracture morphology, neurologic status, and surgeon preference play major roles in deciding on an anterior, a posterior, or a combined approach. The goal is to optimize neural decompression while providing stable internal fixation over the least number of spinal segments. Short-segment constructs through a single-stage approach (anterior or posterior) have become viable options with advances in instrumentation and techniques. Unstable burst fractures can be treated with anterior-only fixation using a strut graft and a modern thoracolumbar plating system or with a posterior-only construct using pedicle screws and possibly hooks. A circumferential construct is considered for extremely unstable injuries.
authors.affiliation: Department of Orthopaedics, University of Wisconsin, Madison, Wisconsin, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Zdeblick
authors.forename: Rick C
authors.initials: RC
authors.lastname: Sasso
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: Jens R
authors.initials: JR
authors.lastname: Chapman
authors.forename: Mitchel B
authors.initials: MB
authors.lastname: Harris
mesh_terms: D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*