When Is Surgery Indicated for Thoracolumbar Burst Fractures?

Burst fractures of the thoracolumbar spine are a common injury and can be source of great pain and disability. Fortunately, in most instances, treatment can be nonoperative with excellent results. However, there are certain situations in which a surgical approach may be indicated: a fracture with a significant neurological deficit or an “unstable” burst fracture with disruption of the posterior ligamentous complex. The literature is reviewed and surgical outcomes are presented.