Conservative treatment of burst fractures of the thoracolumbar and lumbar spine.

Twenty-three patients with burst fracture of the thoracolumbar and lumbar spine were treated nonoperatively. Among these 23 patients, 13 had a neurological deficit and 10 patients did not have such a deficit. Union of burst fractures occurred with conservative treatment in 22 out of 23 patients, but late operation was necessary in only one patient, who had an increasing kyphotic deformation. Of the 13 patients with neurological deficit, 8 showed full recovery and none had neurological deterioration. It was observed by CT scans that the narrowing of the spinal canals was progressively relieved by natural remodelling of the fragments retropulsed into the spinal canal.