Abstract
1. The results of treatment have been compared in two unselected series of patients with unstable fractures of the thoraco-lumbar spine accompanied by paraplegia.
2. One group had been treated by conservative or " postural" methods while the others had been subjected to open reduction and internal fixation with double plates.
3. No difference in the amount of neurological recovery could be detected between the two groups but while a number of conservatively treated patients had significant residual spinal deformity and subsequently developed serious pain, this did not occur in any of the patients treated by plating.
4. It is concluded that open reduction and internal fixation are indicated in displaced fractures in the interests of long-term spinal function.