Nonsurgical treatment of thoracolumbar spinal fractures

The transitional anatomy of the thoracolumbar spine makes it vulnerable to injury from high-energy vehicular crashes and falls. The definitive management of patients with thoracolumbar spinal fractures is dependent on the presence and extent of neurologic injury, the presence and magnitude of acute deformity, and an estimate concerning spinal stability. It is well established that neurologic deficits generally improve without surgery. Nonsurgical treatment leads to decreased pain and improved function. Although there is a dearth of high-quality studies comparing surgical with nonsurgical treatment, the natural course of thoracolumbar fractures usually is benign, and nonsurgical methods should be the standard treatment with few exceptions.