[Spontaneous "regeneration" of the spinal canal in traumatic bone fragments after fractures of the thoraco-lumbar transition and the lumbar spine].

This is a report about four patients in whom spontaneous remodelling of the spinal canal was observed after thoracolumbar fractures with intraspinal bone fragments leading to narrowing by 33-93%. One of the patients was female and three male; two patients had partial neurologic deficits and two had none. The ages of the patients were 33, 16, 65 and 16 years, and the fractures were localized in one case in segment T-12 in two in L-1 and in one in L-4. Active functional treatment was performed with no repositioning or plastering. The changes in spinal canal narrowing and the bone union were monitored by means of CT scans. The follow-up is 9-27 months. The intraspinal bone fragments gradually disappeared in all cases, while the partial neurologic deficits regressed. All patients are now free of troublesome complaints. We would therefore like to point out that thoracolumbar fractures without complete neurologic deficit that are associated with intraspinal bone fragments, whatever their size, should not immediately be treated by surgery, because conservative active functional treatment with spontaneous remodelling of the spinal canal gives results as good as those of operative treatment with far less risk.