Current view on the treatment of burst fractures of the thoracolumbar spine (literature review). Part I

V.A. Radchenko, K.A. Popsuyshapka, S.A. Teslenko


Surgical treatment of spine injuries was formed accor-ding to the evolutionary development of surgery in general. Thus, the implementation of general anesthesia and antibiotics into the surgical practice urged the development of spine surgery, and first of all damage surgery. The further development of technologies in medicine constantly improves surgical interventions, shortens their time, reduces blood loss and trauma to soft tissues. The purpose of the work was to generalize historical and modern views on the diagnosis, classification and treatment of burst fractures of the thoracolumbar spine. A current view on the diagnosis, classification and prediction of the course of burst fractures of the thoracolumbar spine takes into account, first of all, the morphology and mechanical origin of the damage. The time of providing surgical care depends on the general condition of a patient and his neurological status. It is also very important to take into account the history of the disease, namely whether movements in the limbs were saved right after the injury. In our opinion, this is a very important sign of the further course of the disease. Among the large selection of classifications, in our work we focus on the classification of F. Magler, and we use F. Denis classification modified by T. McCormack when choosing tactics for surgical intervention [13, 14]. The existing surgical classification is quite perfect, but it does not take into account the presence of neurological symptoms, but only the risk of kyphotic deformation, without considering the possibility of rotational displacements. The obtaining of new knowledge in the field of biomechanics and morphology of burst vertebral fractures will improve the diagnosis and classification of damages. There is no unanimity regar-ding the use of different methods of fixation, which prompts us to carry out our own research in this direction.


damage to the spine; burst fracture of the thoracolumbar spine; classification; treatment


Aebi M. AO Spine Manual Principles and techniques /

M. Aebi, V. Arlet, J. Webb // Thieme. — 2007. — Vol. 1. — P. 663.

Aebi M. AO Spine Manual Principles and techniques /

M. Aebi, V. Arlet, J. Webb // Thieme. — 2007. — Vol. 2. — P. 837.

Böhler L. Die Technik der Knochenbruchbehandlung. — Vienna, Austria: Wilhelm Maudrich Verlag, 1929. — Р. 186.

Nicoll E.A. Fractures of the dorsalumbar spine / Nicoll E.A. // J. Bone Joint Surg. — 1949. — Vol. 31-B, W3. — P. 376-394.

Holdworth F.W. Fractures, dislocations, and fracture- dislocations of the spine / Holdworth F.W. // J. Bone Joint Surg. — 1963. — Vol. 45-B. — P. 6-20.

Whitesides T.E. Traumatic Kyphosis of the thoracolumbar spine / Whitesides T.E. // Spine. — 1976. — Vol. 4 — P. 99-107.

Louis K. Surgery of the spine / Louis K. — Berlin, Sprin­ger-Verlag, 1983. — 328 p.

Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries / Spine (Phila Pa 1976). — 1983. — Vol. 8, № 8. — Р. 817-831.

Magerl F. Сlassification of thoracic and lumbar injuries / Magerl F., Aebi M., Gertzbein S.D. et al. // Eur. Spine J. — 1994. — Vol. 3, № 4. — Р. 184-201.

McCormack T. The load sharing classification of spine fractures / McCormack T., Karaikovic E., Gaines R.W. // Spine. — 1994. — Vol. 19. — Р. 1741-1744.

Denis F. Spinal instability as defined by the three co­lumn spine concept in acute spinal trauma / Denis F. // Clin.

Orthop. — 1984. — Vol. 189. — Р. 65-76.

Рерих В.В. Хирургическая тактика и организация специализированной помощи при неосложненных повреждениях позвоночника: Дис… д-ра мед. наук: 14.00.22 /

Рерих В.В. — Новосибирск, 2009. — 410 с.

Радченко В.А., Корж Н.А. Патология позвоночника: Пособие для врачей. — Киев: Здоров’я України, 2013. — 226 с.

Орлов С.В. Нестабильность позвоночника при позвоночно-спинномозговой травме (математическое моделирование, пути совершенствования организации и способов лечения): Автореф. дис… д-ра мед. наук: 14.01.18 / Орлов С. В. — Санкт-Петербург, 2010. — 32 с.

Course of Nonsurgical Management of Burst Fractures with Intact Posterior Ligamentous Complex: An MRI Study / A. Alanay, M. Yazici, E. Acaroglu et al. // Spine. — 2004. — Vol. 29, № 21. — P. 2425-2431.

Dai L.-Y. Conservative Treatment of Thoracolumbar Burst Fractures A Long-term Follow-up Results With Special Reference to the Load Sharing Classification / L.-Y. Dai,

L.-S. Jiang, S.-D. Jiang // Spine. — 2008. — Vol. 33, № 23. — P. 2536-2544.

Conservative treatment of fractures of the thoracolumbar spine / M. Tezer, R. Erturer, C. Ozturk et al. // Int Orthop. — 2005. — Vol. 29, № 2. — P. 78-82.

Shen W.J. Nonoperative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurologic deficit / W.J. Shen, T.J. Liu, Y.S. Shen // Spine. — 2001. Vol. 26. — P. 1338-1345.

Treatment of unstable thoracolumbar junction burst fractures with short- or long-segment posterior fixation an magerl type A fractures / M. Altay, B. Ozkurt, C.N. Aktekin et al. // European Spine Journal. — 2007. — Vol. 16. — P. 1145-1155.

Tezeren G. Posterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus long-segment instrumentation / G. Tezeren, I. Kuru // J. Spinal Disord. Tech. — 2005. — Vol. 18, № 6. — P. 485-488.

Short-Segment Pedicle Instrumentation of Thoracolumbar Burst Fractures: Does Transpedicular Intracorporeal Graf­ting Prevent Early Failure? Randomized Trials / A. Alanay, E. Acaroglu, M. Yazici et al. // Spine. — 2001. — Vol. 33, № 26. — P. 213-217.

Unstable Thoracolumbar Burst Fractures: Anterior-Only Versus Short-Segment Posterior Fixation / R. Sasso, K. Renkens, D. Hanson et al. // J. Spinal Disord. Tech. — 2006. — Vol. 19. — P. 242-248.

Transpedicular Corpectomy and Cage Placement in the Treatment of Traumatic Lumbar Burst Fractures / M. Pham, A. Tuchman, T. Chen et al. // J. Spinal Disord. Tech. — 2015.

Treatment of Thoracolumbar Burst Fractures by Means of Anterior Fusion and Cage / B. Zahra, A. Jodoin, G. Maurais et al. // J. Spinal Disord. Tech. — 2012. — Vol. 25. — P. 30-37.

Successful Treatment of Thoracolumbar Fractures With Short-segment Pedicle Instrumentation / D. Gelb, S. Ludwig, J. Karp et al. // J. Spinal Disord. Tech. — 2010. — Vol. 23. — P. 293-301.

The Use of Screw at the Fracture Level in the Treatment of Thoracolumbar Burst Fractures // O. Guven, B. Kocaoglu, M. Bezer et al. / J. Spinal Disord. Tech. — 2009. — Vol. 22. — P. 417-421.

Anterior Single Segmental Decompression and Fixation for Denis B Type Thoracolumbar Burst Fracture With Neurological Deficiency / R. Shi, H. Liu, X. Zhao et al. // Spine. — 2011. — Vol. 36, № 9. — P. 598-605.

Sasani M. Single-Stage Posterior Corpectomy and Expandable Cage Placement for Treatment of Thoracic or Lumbar Burst Fractures / M. Sasani, A. Fahir // Spine. — 2008. — Vol. 34, № 1. — P. 33-40.

Dai L.-Y. Anterior-Only Stabilization Using Plating With Bone Structural Autograft Versus Titanium Mesh Cages for Two- or Three-Column Thoracolumbar Burst Fractures A Prospective Randomized Study / L.-Y. Dai, L.-S. Jiang, S.-D. Jiang //

Spine. — 2008. — Vol. 34, № 14. — P. 1429-1435.

Three-Column Reconstruction Through Single Posterior Approach for the Treatment of Unstable Thoracolumbar Fracture / Y. Haiyun, G. Rui, D. Shucai et al. // Spine. — 2010. — Vol. 35, № 8. — P. 295-302.

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