[Results after conservatively managed vertebral fractures of the thoracolumbar level with special reference to bony stenosis of the spinal canal].

Seventy-two patients with compression fractures of the lower thoracic and lumbar spine who were treated by the Böhler method from 1972 to 1987 were followed up to compare the clinical signs and the results of conventional radiography and spinal computed tomography. There were 33 men and 39 women with an average age of 44.3 years (23-69 years). Treatment by the Böhler method is indicated for fractures between T12 and L5, which constitute 60% of all vertebral fractures. The main distribution in our patients was T12 (n = 26) and L1 (n = 33). Four patients primarily had neurological symptoms. The mean duration of hospitalization was 16 days (4-54). In our results, back pain is the most frequent complaint. A comparison with the findings on the day of the accident showed that the vertebral deformity decreased in all cases (index: mean accident = 0.64; mean follow-up = 0.82). In the CT scan we found spinal stenosis in up to 30% in 9 patients (12.5%) with no neurological symptoms. Based on these results, the authors recommend the Böhler method in lower thoracic and lumbar compression fractures without neurological symptoms. The main aim of the treatment must be reduction of the vertebral deformity to a minimum in order to maximize the biomechanical integrity of the vertebral column and prevent degenerative changes. The use of computed tomography is recommended even in these fractures because of possible spinal stenosis. CT is accurate, especially in evaluating the nature of facet joint failure.