[Trends and results of treatment of spinal fractures]

As long as simple and efficient operative techniques for stabilizing of injured segments of the vertebral column were missing naturally conservative methods dominated. The fixateur interne and the transpedicular spongiosa bone graft, however, provide operative techniques of high efficiency and technical simplicity, which make a revision of old indicational rules- operation versus conservative treatment - necessary. The example of a stable spine fracture points out that the calculated final result has to be clearly better if risk and effort of an operation should be advantageous for the patient. Both methods show a big difference concerning the space of time. Early functional treatment provides a short period of hospitalization as well as quick mobilization and rehabilitation, whereas operative management is more time consuming in every respect. Beside the operational stress, however, the time factor becomes the most important aspect for the patient. Therefore despite improved operative techniques the rate of stabile spine fractures in which operation is recommended and indicated will remain fairly limited. A different situation, however, we find in unstable fractures of the vertebral column. In this case conservative treatment mostly has no advantage except the avoided risk of an operation. Operative management is time-saving and provides better results. For that reason widening of indication for operative management especially in unstable fractures of spine seems favourable.