Thoracolumbar spine fracture classification
There have been attempts in the past to classify thoracolumbar spine fractures in different ways: according to mechanisms of injury 1) , differentiating between flexion and distraction injuries 2) 3) 4) 5).
Thoracolumbar injury classification and severity score (TLICS)
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 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 6). A simplified system with four categories follows