Decision making in thoracolumbar fractures.

Thoracolumbar fractures occur from any and all forms of trauma. Twenty percent of them may be associated with neurological deficits. In high energy trauma, up to 5% of patients will have non-contiguous fractures (i.e. segmental fractures.) Sixty percent of patients with spinal cord injuries will have associated non-spinal injuries. The management of thoracolumbar fractures continues to evolve. Strong agreements exist in certain aspects of care but significant controversy remains in many other areas. This paper reviews our current diagnostic and therapeutic approach to treating these injuries as of the spring of 2005.