====== Thoracolumbar spine fracture classification ====== {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1F3_IGFYOIaZjkQIAtsvLpWhF4r6_Y1tLvlY2__3U2ryrlpQox/?limit=15&utm_campaign=pubmed-2&fc=20240119064812}} 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]]