• İ. Teoman BENLİ
  • Alper KAYA

J Turk Spinal Surg 2010;21(1):85-118

Thoracolumbar region is the most frequently seen fractures of the spine and also most frequently published articles is about this region. Mainly compression, burst and flexion-distraction fractures occur in this region. There is no concensus about a classification system that gives knowledge about description, treatment guides and prognosis. Load sharing classification and TLICS are important classification systems that’s validity and reliabilities are statistically proven. Most of the compression fractures are treated conservatively. Surgical treatment is recommended for more than 20° kyphosis angle and more than 50 percent compression. Most important factor for surgical treatment in burst fractures is torn Posterior Ligamentous Complex (PLC). Even neurologic deficit is a known indication for surgery, the studies showed that it has no significant effect on neurologic recovery. Level I and II, double controlled, prospective, randomised studies and meta analyses showed that the clinical results are similar in both conservative and surgical treatments, and these studies also showed that there is no difference in correction of kyphotic deformity, neurologic recovery and clinical results in posterior, anterior and combined surgical procedures. Flexion-distraction fractures and fracture-dislocations are extremely unstable injuries and require surgical treatment. As a conclusion description and treatment of thoracolumbar fractures are still controversial and the universally accepted knowledge is limited yet.

Keywords: Thoracolumbar spine fractures, compression fractures, burst fractures, flexion-distraction injuries, fracture-diclocation, classification, diagnosis, treatment.