In that occasion, we found an organized intradural inhibitor order us hematoma sleeve enveloping the conus medullaris. We performed a complete removal of the hematoma with a microsurgical technique without finding the source of bleeding. Surprisingly no screw was found in the spinal canal during the revision surgery. The patient was subsequently sent to a rehabilitation center, and he completely regained the neurological functions in 2 months. A 35-year old patient had a Staphylococcus epidermidis infection with surgical wound dehiscence. The patient had been submitted to MIS for a type A2 T11 fracture. Two and a half after surgery underwent surgical debridement and removal of the instrumentation resulting in healing of the infection. The patient wore a 3-point bodice for further 45 days, and the fracture healed with a residual kyphosis of 18 degrees.

Both late postoperative complications were major. In one case there was a nonunion in a patient with an A3 type T12 fracture, with initial kyphosis of 25��. Three months after surgery the patient still complained pain during weight bearing, and there was no evidence of healing on the CT scan. The patient underwent anterior fusion by thoracoscopic approach with incomplete pain relief. In the other case, there was an aseptic loosening of the screws in L5 in a young patient of 28 years, treated 3 years earlier by L3�CL5 MIS for a B2 type L4 fracture. The patient had been scheduled for instrumentation removal 6 months after surgery, but he refused the operation. The patient underwent minimally invasive removal of fixation, with immediate disappearance of pain.

5. Discussion The choice of treatment of the thoracic and lumbar spine injuries is related to many factors such as the type of fracture, the presence of neurological damage, associated injuries, patient’s age, and others more. Conservative treatment of stable vertebral fractures is proposed with success by many authors [2, 3, 9�C11], with different techniques: bed rest followed by external orthoses, extension gymnastics, plaster jacket in bed, or stand reduction [12]. Regardless of the methodology adopted, the treatment should be continued for a period of at least 3-4 months during which the patient care and cooperation is mandatory. The problems related to bed rest, particularly in the elderly, are countless, although difficult to calculate.

Deep vein thrombosis may affect up to 30% of patients. Obesity, chronic obstructive pulmonary disease, venous incompetence, Brefeldin_A and psychiatric disorders are almost absolute contraindications to conservative treatment. In addition, today more and more patients need to return to their social and working life in a short time; therefore, surgery becomes the simplest way to shortcut recovery. In our experience, only 15% of the patients eligible for MIS opted for a conservative treatment.