The surgical treatment of thoracic and lumbar fractures by posterior approach

A review of large case series, biomechanical studies and the development of surgical approaches and various types of instrumentation have led to different orientations in the surgical treatment of vertebral fractures. The authors present their experience in 67 cases treated by posterior approach using segmental fixation for the instability of the lesion and the possible association of neurologic deficit (Magerl A in 35 cases, B in 25, C in 7; Frankel A in 21 cases, B in 15, C in 9, D in 6). At a mean follow-up of 3 years, treatment by posterior approach allowed us to suitably treat most of the vertebral fractures observed with clinically satisfactory results, but without observing a definite correlation between neurologic recovery and quality of the reduction. The overall realignment of the spine with extension synthesis and adequate geometry and the development of good bone callus allowed us to obtained a stable spine, protecting consolidation of the fractured metamere.