[Indications status and surgical treatment of spinal fractures. Attempt at a survey and determination of present status].

Indications for operative treatment of spinal fractures sometimes are difficult to work out. Undoubtedly deteriorating neurological deficits require decompression always combined with stabilization. Due to new classifications a severe instability of the fracture, an axis deviation more than 25 degrees and polytraumatized patients show up being an indication for operative treatment. A proper preoperative planning with use of X-rays and CT Scan as well as the knowledge of the kind and site of instability is mandatory. In cervical spine fractures anterior fusion seems to be the best method. In thoracic spine fractures dorsally attached plates give enough stability. In the thoraco-lumbar spine region and in the lumbar spine itself the internal fixator with dorsal instrumentation together with a transpedicular bone graft is preferred by the authors. Among 384 fractures of the spine 62 have been operated. Both kinds of treatment do not compete; they are complementary instead.