In younger patients, fracture is more likely to occur due to a high-energy trauma, such as motor vehicle accident, motorcycle accident, and falling injury. The causes of thoracolumbar fracture are different depending on patient's age. Especially, the majority of thoracolumbar injuries occur at the T11 to L2 level, which is the biomechanically weak for stress. Ninety percent of all spine fractures are related to the thoracolumbar region. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity. It is still controversial for the use of these treatments because there have not been verified evidences yet. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. However, it is still debatable about the treatment methods. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. The most common fractures of the spine are associated with the thoracolumbar junction.
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