Injuries of the thoracic spine and the thoracolumbar junction

Fractures of the thoracic and thoracolumbar spine are common both in low- and high-energy injuries. Most of the fractures can be treated conservatively; however surgical intervention may be required in unstable injuries and those with spinal cord involvement. This article describes the biomechanics of the thoracic and thoracolumbar regions of the spine, explains the classification of the fracture and injury patterns and provides guidance on the decision-making for surgical management. Special considerations with regards to the approaches and length of fixation in each fracture pattern are mentioned. Categories such as fractures on the background of osteoporosis or ankylosing spondylitis are also covered.