Abstract
Spinal trauma surgery has evolved as a separate subspecialty within a wide range of spinal disorders. In this context, this supplement is a logical step forward, because it brings together all relevant aspects of spine trauma treatment, following systematically the medical aspects and focusing specifically on the indications for treatment. Although the supplement is primarily intended to serve surgeons specialized in spine care, it may also be useful to all physicians who deal with spine trauma, as it will help them get a better picture of the specific indications for conservative and operative treatment with the goal to maximize the chances for a successful treatment of spinal injuries.
In this relatively defined field of spine trauma treatment, the major inherent problems concerning data evaluation are well known. They are due to acuteness of the patient’s condition, distribution of cases among multiple centers—especially in Europe—and a highly variable mix of spinal injuries and comorbidities. As a result, numerous underpowered and therefore often controversial studies were published. Hence, a vast majority of textbooks, reviews, guidelines, and publications that attempt to synthesize the literature usually conclude that further research is needed and no distinct recommendation can be made. However, treating physicians must make prompt therapeutic decisions on a daily basis, regardless of the quality of literature. Therefore, the experience of surgeons gained over decades of specialization in this particular field is of extraordinary importance. Therefore, this supplement summarizes the unique clinical experience of the members of the Spine Section of the German Society for Orthopaedics and Trauma in the treatment of spinal trauma.
As the authors come from Germany, a country that has the ability to cover all its citizens with medical insurance and an up-to-date, high-level medical care, the readership should be aware that the experience expressed in this supplement may differ from that in other parts of the world. This, however, should not be perceived as limitation of the applicability of the experience, but rather as a contribution of the “German approach” to the world literature of spine trauma treatment.
The recent decades have seen an explosion of innovations, significant progress, as well as increasing complexity of spine trauma management. Several new surgical techniques and treatment options like percutaneous fracture stabilization, thoracoscopic anterior spinal stabilization, and so on have been established and are included in this supplement. However, due to the continuous medical progress, obviously further changes are already taking place even during the process of publishing this supplement, leaving the reader with a “snapshot” of the development of the body of knowledge.
The authors, all experts in spine trauma care, have used their long-term clinical experience to formulate recommendations that may be helpful in the efforts to provide the patients with the best possible treatment. The German Society for Orthopaedics and Trauma supports and funds this supplement with the goal to make the decision of surgeons in the everyday practice easier and ultimately with the intention to bring benefit to both, the readers and their patients.