[Indications, technique and results of monosegmental dorsal spondylodesis in wedge compression fractures (grade II) of the thoracolumbar spine].

The management of wedge compression fractures of the thoracolumbar spine remains a controversial subject. Although there is an increasing tendency for operative intervention of spinal injuries, non-operative treatment of compression fracture has been the method of choice. The compression fracture is a fracture occurring during compressive forces of the anterior column due to flexion mechanisms. The more severe the compressive fracture, the more likely it will be to present, in an addition to anterior wedging, a failure of the posterior column indicating tension forces at that level. These fractures, defined as mechanically unstable and classified as compression fractures Grade II, are concentrated in the thoracolumbar region. Between June 1987 and July 1990 14 patients with compression fractures Grade II were treated posteriorly with one level internal fixation. Of the 14 patients, 9 had stabilization with plates and cerclage wire, 5 with an internal fixator. All patients received a localized fusion. In order to permit a more reliable analysis of the results of our stabilizing procedures, a comparison was made with a series of 11 cases with equivalent fractures treated non-operatively between 1986 and 1989. At clinical and radiographic follow-up evaluation, the results in the operative group were much more favourable, both subjective and objective, than in the non-operative group. We derive from these results that in thoracolumbar compression fractures Grade II, posterior one level stabilization and fusion is a recommendable surgical procedure.