Spinal canal remodeling after thoracolumbar fractures with intraspinal bone fragments. 17 cases followed 1-4 years

The long-term fate of nonreduced intraspinal bone fragments in 17 thoracolumbar fractures--three not operated on and 14 stabilized with Harrington's rods or a Hartshill rectangle--was studied with CT. The reduction of the spinal canal area was measured in conjunction with the trauma in the nonoperated on cases and immediately after surgery in the other cases. The mean reduction was 29 (10-70) percent. The reduction had decreased to 14 (0-30) percent at the follow-up examination 31 (12-44) months later. The restitution of the spinal canal did not differ in the nonoperated and operated on patients. Our findings indicate that stable thoracolumbar fractures with intraspinal bone fragments, but without neurologic symptoms, can be treated nonoperatively, irrespective of the size of the fragment, without risk of subsequent symptomatic neural compression.