Staged procedure of immediate posterior fracture reduction and instrumentation within 24 hours (“day 1 surgery”)

followed by scheduled 360° completion fusion during a physiological “time-window of opportunity” (> 3 days after trauma), if an adjunctive anterior decompression and fusion is indicated for neurological or biomechanical reasons. This concept differs from the more common elective strategy of a staged spine fixation by initial posterior fixation and delayed anterior completion by its timeliness (posterior fixation within 24 h) and expanded applicability to all unstable thoracolumbar fractures, including pure anterior column burst fractures (AO/OTA type A3).