Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 93. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | Thoracolumbar Spinal Injuries Chapter 31 919 fixation. Depending on the persistence of spinal canal compromise or comminution of the fractured vertebral body an additional anterior approach is needed. Transpedicular cancellous bone grafting for interbody fusion after posterior stabilization is not recommended in complete or incomplete burst fractures. Only incomplete Type A burst fractures with intact pedicles and a lower endplate should be considered for posterior monosegmental reduction and stabilization. Compared to the open method minimally invasive surgery reduces postoperative pain shortens hospitalization leads to early recovery of function and reduces morbidity of the operative approach. A combined posterior and anterior approach is used to reduce and stabilize severely comminuted vertebral body fractures and to decompress the spinal canal. In Type C lesions often multisegmental instrumentation is needed to reliably stabilize the spine. Complications. The reported complication rate in the literature varies largely and ranges from to 10 . Postoperative neurological complications range from to . Only honest and accurate assessment of complications will lead to scientific and clinical progress. Key Articles Bohler L 1951 Die Technik der Knochenbruchbehandlung. Maudrich Vienna Lorenz Bohler was one of the first to advocate a conservative treatment with fracture reduction and retention in a cast. Roaf R 1960 A study of the mechanics of spinal injuries. J Bone Joint Surg Br 42B 810-23 In this article Roaf studies the biomechanics of spinal injuries and describes the results of studies of spinal units when subjected to forces of different magnitude and direction . compression flexion extension lateral flexion rotation and horizontal shear. Denis F 1983 The three column spine and its significance in the classification of acute thoraco-lumbar spinal injuries. Spine 8 817-31 This article is a presentation of the concept of the three-column spine. The .
