Osteotomy for Traumatic Spinal Deformity

The most common region of spinal fracture is the thoracolumbar (T11–12), mainly due to the characteristics of anatomical position and biomechanical of thoracolumbar segment. The thoracic spine has thoracic cage support, with a smaller vertebral body, narrow intervertebral space, long and overlapping spinous processes, and short interspinous ligaments. The articular processes of the thoracic spine are on the coronal plane. All these factors limit the activity of the thoracic spine, so the fracture rarely occurs in the T1–T10 vertebral body. T11–T12 vertebrae are similar to the lumbar vertebrae in structure. Ribs have little stabilizing effect on the corresponding vertebrae due to their free ends. These vertebrae are located in the transition zone of the thoracic spine with less activity and the lumbar spine with more activity. When the spine is subjected to hyperextension or axial compression violence, it is easy to cause compression or burst fracture of the vertebral body. As the complex structure of the posterior vertebral ligament is relatively intact, local kyphosis with fracture vertebral body as the center often occurs after the injury, which is the main reason that traumatic kyphosis is commonly found in the thoracolumbar levels.