Hot issues in diagnosis and treatment of thoracolumbar fractures

Abstract

In recent years, the surgical treatment of thoracolumbar fractures has made great progress. The thoracolumbar injury classification and severity score (TLICS) of thoracolumbar injuries and the new AO classification, as the most widely used classification score in clinical application, have a clear guiding significance for clinical treatment and scientific research. With the extensive application of CT and MRI, the divergence in the diagnosis of posterior ligament complex (PLC) injury in scoring systems has been narrowed. With the wide application of pedicle screw and the deeper understanding of the anatomical and mechanical characteristics of spine, posterior pedicle screw fixation has been gradually adopted as the major method, while anterior or posterior pedicle screw fixation is only used in special cases. Because of the in-depth study of pedicle screw mechanics, more and more attention has been paid to the fixation of injured vertebrae. Moreover, with the intensive study of sagittal balance of the spine, the reconstruction of injured vertebrae has been proposed as a new concept and further investigated. The author discusses thoracolumbar fracture scoring system, surgical approach, surgical fixation segment, bone graft reconstruction and minimally invasive treatment so as to provide some reference. Key words: Spinal fractures; Thoracic vertebrae; Lumbar vertebrae