Advertisement

A Comprehensive Classification of Thoracic and Lumbar Injuries

  • F. Magerl
  • M. Aebi
Chapter

Abstract

A classification should allow the identification of any injury by means of a simple algorithm based on easily recognizable and consistent radiographic and clinical characteristics. In addition, it should provide a concise and descriptive terminology, information regarding the severity of the injury, and guidance as to the choice of treatment and should serve as a useful tool for future studies.

Keywords

Vertebral Body Spinal Canal Burst Fracture Thoracolumbar Spine Neural Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Arciero R, Leung K, Pierce J (1989) Spontaneous unstable burst fracture of the thoracolumbar spine in osteoporosis. Spine 14:114–117PubMedCrossRefGoogle Scholar
  2. 2.
    Boger DC, Chandler RW, Pearce JG, Balciunas A (1983) Unilateral facet dislocation at the lumbosacral junction. J Bone Joint Surg [Am] 65: 1174–1178Google Scholar
  3. 3.
    Bohler L (1951) Die Technik der Knochenbruchbehandlung, 12–13 edn, vol 1. Maudrich, Vienna, pp 318–480Google Scholar
  4. 4.
    Bohler J (1983) Bilanz der konservativen und operativen Knochenbruchbehandlung - Becken und Wirbelsäule. Chirurg 54: 241–247PubMedGoogle Scholar
  5. 5.
    Chance CQ (1948) Note on a type of flexion fracture of the spine. Br J Radiol 21: 452–453PubMedCrossRefGoogle Scholar
  6. 6.
    Conolly PI, Esses StI, Heggeness MH, Cook StS (1992) Unilateral facet dislocation of the lumbosacral junction. Spine 17: 1244–1248CrossRefGoogle Scholar
  7. 7.
    De Oliviera J (1978) A new type of fracture-dislocation of the thoracolumbar spine. J Bone Joint Surg [Am] 60: 481–488Google Scholar
  8. 8.
    Delplace J, Tricoit M, Sillion D, Vialla IF (1983) Luxation postérieure de L5 sur le sacrum. A propos d’un cast Rev Chir Orthop 69: 141–145Google Scholar
  9. 9.
    Denis F (1982) Updated classification of thoracolumbar fractures. Orthop Trans 6: 8–9Google Scholar
  10. 10.
    Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8: 817–831PubMedCrossRefGoogle Scholar
  11. 11.
    Denis F (1984) Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop 189: 65–76PubMedGoogle Scholar
  12. 12.
    Denis F, Burkus JK (1991) Lateral distraction injuries to the thoracic and lumbar spine. A report of three cases. J Bone Joint Surg [Am] 73:1049–1053Google Scholar
  13. 13.
    Denis F, Burkus JK (1991) Diagnosis and treatment of cauda equina entrapment in the vertical lamina fracture of lumbar burst fractures. Spine [Suppl] 16: 433–439Google Scholar
  14. 14.
    Denis F, Burkus JK (1992) Shear fracture dislocation of the thoracic and lumbar spine associated with forceful hyper-extension (lumberjack paraplegia). Spine 17: 156–161PubMedCrossRefGoogle Scholar
  15. 15.
    Ferguson RL, Allen BL Jr (1984) A mechanistic classification of thoracolumbar spine fractures. Clin Orthop 189: 77–88PubMedGoogle Scholar
  16. 16.
    Fuentes JM, Bloncourt J, Bourbotte G, Castan P, Vlahovitch B (1984) La fracture du chance. Neurochirurgie 30: 113–118PubMedGoogle Scholar
  17. 17.
    Gertzbein SD, Court-Brown CM (1988) Flexion/distraction injuries of the lumbar spine. Mechanisms of injury and classification. Clin Orthop 227: 52–60PubMedGoogle Scholar
  18. 18.
    Gertzbein SD, Court-Brown CM (1989) The rationale for management of flexion/distraction injuries of the thoracolumbar spine, based on a new classification. J Spinal Disord 2 : 176–183.PubMedCrossRefGoogle Scholar
  19. 19.
    Gertzbein SD, Offierski C (1979) Complete fracture-dislocation of the thoracic spine without spinal cord injury. A case report. J Bone Joint Surg [Am] 61: 449-451Google Scholar
  20. 20.
    Gumley G, Taylor TKF, Ryan MD (1982) Distraction fractures of the lumbar spine. J Bone Joint Surg [Br] 64: 520–525Google Scholar
  21. 21.
    Holdsworth FW (1963) Fractures, dislocations, and fracture dislocations of the spine. J Bone Joint Surg [Br] 45: 6–20Google Scholar
  22. 22.
    Holdsworth FW (1970) Review article: fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg [Am] 52:1534–1551Google Scholar
  23. 23.
    Howland WJ, Curry JL, Buffington CD (1965) Fulcrum injuries of the lumbar spine. JAMA 193: 240–241PubMedCrossRefGoogle Scholar
  24. 24.
    Jeanneret B, Ward J-C, Magerl F (1993) Pincer fractures: a therapeutic quandary. Rev Chir Orthop 79 (Spécial): Abstract 38Google Scholar
  25. 25.
    Jeanneret B, Ho PK, Magerl F (1993) “Burst-shear” flexion/ distraction injuries of the lumbar spine. J Spinal Disord 6: 473–481PubMedCrossRefGoogle Scholar
  26. 26.
    Lindahl S, Willen J, Norwall A, Irstam L (1983) The crush-cleavage fracture. A “new” thoracolumbar unstable fracture. Spine 8: 559–569PubMedCrossRefGoogle Scholar
  27. 27.
    Lob A (1954) Die Wirbelsäulen-Verletzungen und ihre Ausheilung. Thieme, StuttgartGoogle Scholar
  28. 28.
    Louis R (1977) Les théories de l’instabilite. Rev Chir Orthop 63: 423–425PubMedGoogle Scholar
  29. 29a.
    Magerl F, Harms J, Gertzbein SD, Aebi M, Nazarian S (1990) A new classification of spinal fractures. Presented at the Societé Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) Meeting, Montreal, September 9,1990Google Scholar
  30. 29b.
    Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine JGoogle Scholar
  31. 30.
    Maruo S, Tatekawa F, Nakano K (1987) Paraplegie infolge von Wirbelkompressionsfrakturen bei seniler Osteoporose. Z Orthop 125: 320–323PubMedCrossRefGoogle Scholar
  32. 31.
    McAfee PC, Yuan HA, Fredrickson BE, Lubicky JP (1983) The value of computed tomography in thoracolumbar fractures. An analysis of one hundred consecutive cases and a new classification. J Bone Joint Surg [Am] 65: 461–479Google Scholar
  33. 32.
    Müller ME, Nazarian S, Koch P (1987) Classification AO des fractures. I Les os longs. Springer-Verlag, Berlin Heidelberg New YorkGoogle Scholar
  34. 33.
    Nicoll EA (1949) Fractures of the dorso-lumbar spine. J Bone Joint Surg [Br] 31: 376–394Google Scholar
  35. 34.
    Powell J, Waddell J, Tucker W, Transfeldt E (1989) Multiple-level noncontiguous spinal fractures. J Trauma 29: 1146–1150PubMedCrossRefGoogle Scholar
  36. 35.
    Rennie W, Mitchell N (1973) Flexion distraction injuries of the thoracolumbar spine. J Bone Joint Surg [Am] 55: 386-390Google Scholar
  37. 36.
    Roy-Camille R, Saillant G (1984) Les traumatismes du rachis sans complication neurologique. Int Orthop 8:155–162PubMedCrossRefGoogle Scholar
  38. 37.
    Roy-Camille R, Saillant G, Berteaux D, Marie-Anne S (1979) Early management of spinal injuries. In: McKibbin B (ed) Recent advances in orthopaedics 3. Churchill Livingstone, Edinburgh, pp 57–87Google Scholar
  39. 38.
    Roy-Camille R, Gagnon P, Catonne Y, Benazet JB (1980) La luxation antero-laterale du rachis lombo-sacre. Rev Chir Orthop 66:105–109PubMedGoogle Scholar
  40. 39.
    Salomon C, Chopin D, Benoist M (1988) Spinal cord compression: an exceptional complication of spinal osteoporosis. Spine 13: 222–224PubMedCrossRefGoogle Scholar
  41. 40.
    Sasson A, Mozes G (1987) Complete fracture-dislocation of the thoracic spine without neurologic deficit. A case report. Spine 12: 67–70PubMedCrossRefGoogle Scholar
  42. 41.
    Shikata J, Yamamuro T, Iida H, Shimizu K, Yoshikawa J (1990) Surgical treatment for paraplegia resulting from vertebral fractures in senile osteoporosis. Spine 15:485–489PubMedCrossRefGoogle Scholar
  43. 42.
    Simpson AHRW, Williamson DM, Golding SJ, Houghton GR (1990) Thoracic spine translocation without cord injury. J Bone Joint Surg [Br] 72: 80–83Google Scholar
  44. 43.
    Smith WS, Kauter H (1969) Patterns and mechanics of lumbar injuries associated with lap seat belts. J Bone Joint Surg [Am] 51: 239–254Google Scholar
  45. 44.
    Trojan E (1972) Langfristige Ergebnisse von zoo Wirbelbrüchen der Brust-und Lendenwirbelsäule ohne Lähmung. Z Unfallmed Berufskr 65: 122–134PubMedGoogle Scholar
  46. 45.
    White AA III, Panjabi MM (1978) Clinical biomechanics of the spine. Lippincott, PhiladelphiaGoogle Scholar
  47. 46.
    Whitesides TE Jr (1977) Traumatic kyphosis of the thoracolumbar spine. Clin Orthop 128: 78–92PubMedGoogle Scholar
  48. 47.
    Willems MHA, Braakman R, Van Linge B (1984) Bilateral locked facets in the thoracic spine. Acta Orthop Scand 55: 300–303PubMedCrossRefGoogle Scholar
  49. 48.
    Willen J, Lindahl S, Irstam L, Aldman B. Norwall A (1984) The thoracolumbar crush fracture. An experimental study on instant axial dynamic loading: the resulting fracture type and its instability. Spine 9: 624–630PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • F. Magerl
  • M. Aebi

There are no affiliations available

Personalised recommendations