The Concept of Evolution of Thoracolumbar Fracture Classifications Helps in Surgical Decisions.

The Concept of Evolution of Thoracolumbar Fracture Classifications Helps in Surgical Decisions. Asian Spine J. 2015 Dec;9(6):984-94 Authors: Azam MQ, Sadat-Ali M Abstract Since Boehler's sentinel description, a universally acceptable thoracolumber fracture classification has eluded spine surgeons. The concept of the stability of a thoracolumbar injury changed continuously from the two column concept of Holdsworth to the three column theory of Denis. With the advent of sophisticated imaging techniques, improved biomechanical understanding, and in order to meet the high expectations of patients, several classification systems have been forwarded by the stalwarts in the field. Each successive system has contributed significantly to the understanding and prediction of treatment outcome. Load sharing classification by McCormack attempted to rationalize the use of short segment posterior instrumentation. Magerl et al. developed a comprehensive classification system based on progressive morphological damage determined by three fundamental forces: compression, distraction, and axial torque. Vaccaro et al. devised the thoracolumbar injury severity score based on three independent variables: the morphology of the injury, posterior ligamentous complex (PLC) integrity, and neurological status at the time of injury. But, there are limitations to the classification system, especially when magnetic resonance imaging yields a PLC status as indetermi...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research