Treatment options for thoracolumbar spine fractures.

A decision for operative versus nonoperative management of thoracolumbar fractures should NEVER be based solely on one factor. Only after a thorough physical, neurological, and spinal examination, and an assessment of a patient's prior activity, social and educational background and patient's expectations, one should review the patient's radiographs and CT scans to determine risks and benefits of operative versus nonoperative care. Both treatment options are discussed in this paper. As a surgical option our preference is short-segment instrumentation and fusion. Careful and appropriate patient selection and an excellent operative technique insure the minimum complications.