Spinal fracture in polytrauma situation

The timing of surgical stabilization of a thoracolumbar spine fracture in a polytrauma situation is controversial. While delayed surgery was considered safe and the norm, over the last few years there is an increasing amount of literature available that supports early stabilization of the spine fracture with good neurological and non-neurological outcomes. Adequate “resuscitation” of the patient prior to surgical intervention is of paramount importance to reduce surgery associated “second hit”. The “spine damage control” approach is a safe and appropriate management strategy in a polytrauma situation. Minimally invasive stabilization follows the principles of “damage control orthopedics” and appears to be a good surgical option.