Decision making in the treatment of thoracolumbar fractures

Traumatic spine fractures are serious injuries, that can be devastating for patients without appropriate treatment. The incidence of spinal trauma is increasing over the years. Five to nine percent of all trauma patients suffer from spinal trauma.1,2 Almost one‐third of the spinal trauma injuries is due to motor‐vehicle accidents. The incidence of mortality however decreased over the last three decades.3 In 1996 Hu4 published a cross section observational study of a 3‐year cohort between 1981‐1984, with a mortality of 41%. In 2012 Oliver2 showed in his study a decrease in mortality from ±15% in 1996 to 5‐6% in 2008. One of the reasons may be due to improved traffic safety
standards and health care, such as emergency and intensive care.
Most of thoracolumbar fractures occur at the thoracolumbar junction (Th11‐L2), followed by the thoracic spine. The lower lumber spine is least affected.3 Spinal fractures are most frequently observed in the young and active population, more often in males than females.5,6 The incidence of neurological deficit varies from 22‐51% depending on fracture type and localization.