A clinical study of the natural remodeling of burst fractures of the lumbar spine.

Surgical decompression and fixation are considered by many to be the preferred treatment for burst fractures of the lumbar spine, regardless of neurologic deficit. For 6 patients with burst fracture of the lumbar spine but without neurologic deficit, computed tomography scans revealed >50% encroachment of the spinal canal. All 6 patients were treated conservatively, and during the followup period (range, 6-49 months), the narrowing of the spinal canal decreased progressively because of resorption of the fragments and natural remodeling. The presence of a neurologic deficit should be the primary indication for surgery in patients with a burst fracture of the lumbar spine.