Therapeutic Decision Making in Thoracolumbar Spine Trauma

摘要: Study design Systematic literature review. Objective A systematic review was designed to answer 3 primary research questions: (1) What is the most useful classification system for surgical and nonsurgical decision-making with regard thoracolumbar (TL) spine injuries? (2) For a TL burst fracture incomplete neurologic deficit, what optimal approach stabilization technique? (3) Is complete disruption of posterior ligamentous complex an indication intervention fractures? Summary background data Despite long history descriptive clinical series, there remains considerable controversy wide variation in treatment traumatic injuries. Methods comprehensive search English conducted using Medline Cochrane Database Reviews. Standardized grading systems were used assess level evidence quality articles impacting questions. Results Recommendations questions as follows: Thoracolumbar Injury Classification System seems be best available therapeutic injuries (strength recommendation: weak; evidence: low). There no specific case deficit that has any advantage recovery Complete determined collectively by morphologic criteria plain radiographs computed tomography fractures strong; Conclusion Based on this only very low moderate studies could identified address related trauma. These findings suggest need further study, including emphasis higher studies.