[Changes in the approach and methods of acute surgical treatment in severe thoraco-lumbar spinal injuries].

The authors show the changes in the approach and methods concerning the acute surgical treatment of severe thoracolumbar spinal injuries. In the past 15 years, 878 acute surgical treatments have been done with ventral-, dorsal or combined method. The results are evaluated from the point of view of neurological function recovery, bony union, restoration of patients' comfort and complications. Authors discuss the changes of past 15 years regarding the basic ideas of the treatment of spinal injuries, the indications and methods of modern surgical techniques. The use of new surgical methods which are closely connected to the biomechanical characteristics of the injured spine are stressed, as well as the importance of the primary definitive ventral surgical treatment, in the case of a severe thoraco-lumbar spine injury.