37 - Thoracic and Lumbar Spine Injuries

Abstract

Fractures of the thoracolumbar region are among the most common injuries of the vertebral column, especially in middle-aged men. The transition from a relatively rigid thoracic spine to a flexible lumbar spine makes this region susceptible to mechanical stress and resultant injury. Half of fractures resulting from significant trauma within this region are unstable, and injuries can result in physical deformity and permanent neurological injury. Several classification systems have been proposed to guide treatment algorithms for thoracolumbar injury, incorporating aspects such as fracture stability, neurological status, and complications. Currently, four major classification systems exist: the Denis three-column system, the Margel AO system, the Thoracolumbar Injury Classification and Scoring system, and most recently the AOSpine Thoracolumbar Injury Classification system. The most recent AOSpine thoracolumbar injury classification system, along with its corresponding thoracolumbar AOSpine injury score, provides a trauma treatment algorithm for thoracolumbar injury that reflects international practices.