Chapter 22 - Biomechanics of Vertebral Fractures and Their Treatment

Abstract

Spinal injuries are common and potentially devastating injuries. The thoracolumbar spine constitutes the most common site of spinal injuries. Depending on the mechanism of injury as well as the predominant forces and moments acting on the spine at the time of injury, typical thoracolumbar injury patterns result. The wide spectrum of thoracolumbar injuries is classified according to the AOSpine thoracolumbar spine injury classification system and varies from insignificant transverse process fractures to multidirectionally unstable injuries with complete spinal cord injury. Treatment options range from conservative to combined posteroanterior stabilization depending on the specific injury pattern. Posterior-only fixations using pedicle screw/rod constructs are most widely used to realign and stabilize the injured thoracolumbar spine. However, in thoracolumbar injuries with severe anterior column compromise, combined posteroanterior stabilization represents the treatment of choice.