[Treatment concepts for fractures of the thoracolumbar junction and lumbar spine]

Abstract

Thoracolumbar vertebral fractures are not only characterized by frequent osteoligamentous instability, but also often by irreversible damage to to the intervertebral disk. Treatment guidelines can be formulated based on an accurate classification system. In addition to reconstructing the axis of rotation, it is crucial that the width of the spinal canal be restored when neurological deficits are present. Both indirect dorsal compression and ventral endoscopically guided direct decompression are equally of decisive importance. To achieve long-term stability with as little corrective loss as possible, the ventral column absorbing pressure is surgically stabilized by diligently resecting a destroyed intervertebral disk and vertebral fragments and replacing it with a corticocancellous bone graft or cage. The goal should always be to keep the fusion length as short as possible.