The Fate of Neglected Three Column Injuries of the Thoracolumbar Spine

Abstract

In a thoracolumbar fracture, accurate diagnosis of spinal stability is necessary in deciding on appropriate treatment options and for prevention of complications that can subsequently occur. In various reports for spinal stability, rupture of the posterior ligament complex is generally accepted as a very important factor of spinal stabiliby. In cases of conservative treatment for unstable thoracolumbar fractures, the progressive kyphotic deformity can cause chronic pain and functional disability, and neurologic deterioration in severe cases. Therefore, the concept of surgical treatment for unstable thoracolumbar fracture has been well established. We report on two cases of neglected three column injury in the thoracolumbar spine, which were treated conservatively due to misdiagnosis at other hospitals, and finally underwent delayed operation in our hospital because of chronic back pain and progressive kyphotic deformity.