[Prognostic importance of the criteria of stability and instability in traumatic injuries of the spine].

A traumatic vertebral lesion is unstable when, in spite of correct and timely reduction and immobilisation, a displacement occurs during the days following the trauma. Prompt correct diagnosis (often impeded by the serious conditions of the patients) and subsequent examinations are of great importance, especially in the case of very small, hardly detectable lesions, which do not involve neurological injuries. A series of some 800 vertebral fractures/dislocations was reviewed and numerical coefficients as proposed by Goutallier et al. were assigned to each case. These criteria were generally valid. However certain predictable unstable lesions for which surgery is indicated despite the absence of neurological lesions were stabilised by synostosis or anatomofunctional blocks even without surgical intervention. In contrast surgical stabilisation is necessary not only in the presence of neurological lesions but also when no sign of repair can be seen and/or vertebral dislocations worsen and/or anomalous vertebral movements arise.