[Acute management of spinal injuries. The thoracic and lumbar spine, surgical therapy].

The aims of internal fixation of thoracic and lumbar spinal fractures are immediate stability, preservation of spine mobility, and restoration of the anatomical form of the vertebra and of the canal diameter at acceptable risks. All these aims together can be achieved only by short posterior pedicle fixation systems, such as the external spine fixator, the various internal spine fixators, special dorsal Roy-Camille plates, Wolter plates, and the combined anterior and posterior unisegmental fusion with the USIS system. Isolated anterior procedures necessitate additional bracing. The indications for operative treatment are discussed in the light of the above-mentioned methods.