Neurosurgery clinics of North America
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Current improvements in radiologic imaging and surgical instrumentation have greatly expanded the role of surgery in management of tumors of the thoracolumbar junction. For primary malignant tumors, the aim of surgery should be curative, with eradiction of all gross disease. For metastatic tumors, indications for surgery include cancer therapy, stabilization, neurologic palliation, tissue diagnosis, and pain relief. Because the thoracolumbar region is a transitional zone, surgical stabilization may require anterior-posterior approaches and instrumentation.
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Neurosurg. Clin. N. Am. · Oct 1997
ReviewClassification and acute management of thoracolumbar fractures.
Successful management of traumatic injuries of the thoracolumbar spine requires understanding of the concepts of spinal stability and instability. There are numerous classifications of injury patterns based on fracture type and the probable forces involved. This article focuses on Denis's three-column theory of spinal stability and its utility in categorizing five injury patterns and the forces involved: specifically, wedge compression fractures, burst fractures, flexion distraction injuries, fracture dislocations, and miscellaneous injuries. The authors also highlight the acute management and evaluation of patients suspected to have these types of injuries.