[Acute management of spinal injuries. The thoracic and lumbar spine, conservative and functional therapy]

Fractures of the thoracic spine are commonly treated functionally. In the thoracolumbar and lumbar region compression fractures with angulation can be treated by closed reduction and casting according to the Boehler method. Yet, stable fractures with minor deformities may be treated with advantage by early weight bearing. Primarily unstable thoracic and lumbar vertebra fractures gradually become stable with increasing fracture healing and may also be treated functionally but with prolonged bed rest of 6-12 weeks. Thus open reduction and internal fixation achieve better anatomical alignment and also allow early mobilisation and ambulation. They are therefore recently favoured.