Principles of vertebral fracture management.

Traumatic disruption of the spine and supporting soft tissue structures may result in vertebral fracture or luxation and subsequent spinal cord compromise. An understanding of the regional anatomy is important to the discussion of pathophysiology and treatment of traumatic disorders. Various traumatic forces result in disruption of specific anatomic structures and reflect inherent stability or instability of the vertebral column. The neurological examination, and sequential neurological examinations, reflect the degree of spinal cord damage and vertebral instability. Patients in whom radiographs show instability, have severe neurological signs or worsening neurological signs, should be treated surgically. Several spinal stabilization techniques are available and their choice is contingent on the location in the spinal column, size of the patient, and the surgeon's experience. The prognosis is determined primarily by the severity of neurological signs, and the stability of the fixation technique.