Thoracolumbar spine fracture classification [Neurosurgery Wiki]

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====== Thoracolumbar spine fracture classification ======

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There have been attempts in the past to classify [[thoracolumbar spine fracture]]s in different ways: according to mechanisms of [[injury]] 
((Ferguson RL, Allen BL., Jr A mechanistic classification of thoracolumbar spine fractures. Clin Orthop. 1984;189:77–88.))
, differentiating between flexion and distraction injuries
((Chance QC. Note on a type of flexion fracture of the spine. Br J Radiol. 1948;21:452–453. doi: 10.1259/0007-1285-21-249-452.))
((Gertzbein SD, Court-Brown CM. Flexion/distraction injuries of the lumbar spine. Mechanisms of injury and classification. Clin Orthop. 1988;227:52–60.))
((Rennie W, Mitchell N. Flexion-distraction injuries of the thoracolumbar spine. J Bone Joint Surg Am. 1973;55:386–390.))
((Smith WS, Kauter H. Patterns and mechanics of lumbar injuries associated with lap seat belts. J Bone Joint Surg Am. 1969;51:239–254.)).

===== Thoracolumbar injury classification and severity score (TLICS) =====

see [[Thoracolumbar injury classification and severity score]].

===== AOSpine thoracolumbar spine injury classification system =====

see [[AOSpine thoracolumbar spine injury classification system]].

===== Denis =====


A widely used model for [[thoracolumbar spine]] [[stability]] is the 3 [[column]] of [[Denis]].

see [[Denis Classification]] and [[Three column model]].

see [[McAfee classification]].




----
see [[Magerl classification of thoracolumbar spinal fractures]].

===== Classification into major and minor injuries =====

==== Minor injuries ====

Involve only a part of a column and do not lead to acute instability (when not accompanied by major injuries). Includes:

1. fracture of the [[transverse process]]: usually neurologically intact except in two areas:

a) L4–5→lumbosacral plexus injuries (there may be associated with renal injuries, check U/A for blood)

b) T1–2→brachial plexus injuries

2. fracture of [[articular process]] or [[pars interarticularis]]

3. isolated fractures of the [[spinous process]]: in the TL spine: these are usually due to direct trauma.
Often difficult to detect on plain X-ray

4. isolated laminar fracture: rare. Should be stable

==== Major injuries ====

The [[McAfee classification]] describes 6 main types of fractures
((Chedid MK, Green C. A Review of the Management of Lumbar Fractures With Focus on Surgical Decision-Making and Techniques. Contemp Neurosurg. 1999; 21:1–5)).
A simplified system with four categories follows 


==== Pediatric Thoracolumbar Spine Fracture ====
[[Pediatric Thoracolumbar Spine Fracture]]