[Management and results of conservative treatment of patients with injuries of the thoracic and lumbar vertebrae].

Conservative treatment of injuries of the thoracic and lumbar spine is indicated in stable fractures without or with an axis angle up to 25 degrees and in children fractures. Stable injuries are compression-wedge-fractures and burst fractures. Severe compression fractures with dorsal ligamentous injuries are regarded being conditional stable. Conservative treatment can be divided into 3 periods: lying period, rising period and stand-walk-sit period. Physiotherapy together with proper nursing is to avoid pulmonary and circulatory complications as well as to support motility of the intestinal tract. After stabilization of the general condition of the patient physiotherapy should furthermore lead to: relaxation of the hypertonic musculature, facilitating and preservation of muscle activities to secure the injured parts of the spine, training and assignment of global, diagonal muscle chains following physiological motions. From 1982-1986 389 patients with fractures of the spine were treated in the Tübingen Accident Hospital (Berufsgenossenschaftliche Unfallklinik Tübingen). An early functional treatment following Bürkle de la Camp was performed in 84%. The follow up examination showed no further displacement in 84%. In 1/3 of the cases a free movement was regarded in the sagittal plane. 2/3 of the cases showed restriction of movement in only one segment. The good functional result is underlined by the subjective impression of the patient themselves: 2/3 were satisfied with the result.