Learning objectives
1.
Discuss the revised AO Thoraco-lumbar (TL) spine injury classification system.
2.
Illustrate the added value of using “The Thoracolumbar injury classification and severity score-TLISC”.
3.
Highlight the different classification systems proposed to evaluate dorsolumbar fractures injuries.
Background
Injuries’ classifications are proposed to create a common language among the members of the healthcare team which is crucial for sound clinical management of injured patients.
Trials to classify traumatic vertebral injuries were based on either mechanism of injury e.g.
Böhler,
different mechanistic descriptors of vertebral column e.g.
Denis three column theory or a combination of both main mechanism of injury,
pathomorphological uniformity e.g.
Magerl’s AO system.
Using Magerl’s AO system,
the AO spine classification group (AOSCG) sat for a revised classification system to address...
Imaging findings OR Procedure Details
The timeline for major spine classification systems is summerizedbelow:
Böhlerproposed the earliest classification system for TL spine fractures.
Based on both anatomic appearance and mechanisms of injury,
TL injuries were divided intocompression fractures,
flexion-distraction injuries,
extension fractures,
shear fractures,
and rotational injuries.
Yet,
he did not attempt to define instability patterns.
Later onWatson-Jones&Nicollrecognized the importance of recognizing unstable fractures in order to avoid long-term neurological sequel as well as skeletal deformities.
Watson-Jones described fractures according to their anatomic appearance with emphasis onligamentous integrity as one...
Conclusion
Many trials were proposed to classify TL injuries.
A classifcation system that is simple,
reliable and clinically relevantis alwaysthe ultimate goal of these classificaiton systems.We recommend using the AO system for this purpose.
The added value of thoracolumbar injury classification and severity scoreis clear in directing patient management and ensuring a favourable patient outcome.
AOTL spine classificationcreates a simple way of communication between radiologists and caring physicians.
References
Reinhold M,
Audigé L,
Schnake KJ,
Bellabarba C,
Dai L-Y,
Oner FC.
AO spine injury classification system: a revision proposal for the thoracic and lumbar spine.
European Spine Journal.
2013;22(10):2184-2201.
doi:10.1007/s00586-013-2738-0.
Aebi M.
Classification of thoracolumbar fractures and dislocations.
European Spine Journal.
2010;19(Suppl 1):2-7.
doi:10.1007/s00586-009-1114-6.
Lee,
Joon Y.
et al.
“Thoracolumbar Injury Classification and Severity Score: A New Paradigm for the Treatment of Thoracolumbar Spine Trauma.” Journal of Orthopaedic Science 10.6 (2005): 671–675.
PMC.
Web.
30 Jan.
2016.
AOSpine Thoracolumbar Classification System.
www.aospine.org/TLclassification
Personal Information
A.
Al-Taie,
H.
A.
H.
A.
Aboughalia,
A.
Y.
I.
Taha,
A.
H.
Marioud,
S.
I.
Alam; Clinical Imaging Department,
Hamad General Hospital,
P.O box: 3050,
Doha/QA.
E-mail:
[email protected]
