[Operative versus conservative treatment of the fractures or dislocations of the thorocolumbar spine associated with neurological deficiency].

The results of treatment of injuries of the thoracic and lumbar spine with neurological involvement, have been rewieved in a retrospective study of 42 patients, of whom 14 received conservative and 28 surgical treatment. Operations were reserved for patients with grossly unstable fracture, fracture-dislocations and pure dislocations. Open reduction and short internal fixation with Roy-Camille plates, were the operative procedures of choice. After the period of "bed rest" conservative treatment 71% of the patients showed clinical instability and 64% constant spinal pain. Only one (3%) operated patient had redeplacement and kyphotic angulation of the injured thoracolumbar spine. Of the patients treated conservatively 56% showed recuperation of the incomplete neurological lesions, as compared as to 53% of those treated surgically. Cases with complete neurological involvement showed some, but statistically significant, improvement only in the operated group of patients. It is concluded that surgical approach had obvious advantages about degree of the complete lesions neural recovery, final stability of the vertebral column and local pain symptoms.