The evaluation of spinal instability due to vertebral fractures is occasionally troublesome. Ligaments and soft tissues are as important as bony structures in maintaining the stability of adult spinal fractures. İn patients with chronic instabilities X-ray pictures in flexion and extension are fundamental. Spinal instability can be evaluated as mechanicai and neurological. Ligamentous structures and soft tissues have an important role in the mechanical stability of the thoracolumbar spine. Some spinal injuries with soft tissue component can be miss-diagnosed as stable and they may be treated inappropriately. However, they may become unstable as time progresses. Vertebral fractures with multilevel involvement are usually determined as unstable, hovvever, the surgical treatment of these fractures is not well ascertained. Furthermore, the stability of spinal fractures with more than one segment involvement, needs to be evaluated. Spinal injuries in children may cause neurological problems even a fracture is not present in the X-ray. On the other hand, tumoral metastasis of the vertebral bodies should be differentiated from fractures related to osteoporosis in elderly patients.

Keywords: Spine, Fracture, Stability.