MEM Research Center for Orthopaedic Surgery, Institute for Evaluative Research in Orthopaedic Surgery, University of Berne, Stauffacherstrasse 78, 3014, Bern, Switzerland.
Eur Spine J. 2010 Mar;19 Suppl 1(Suppl 1):S2-7. doi: 10.1007/s00586-009-1114-6. Epub 2009 Oct 23.
A classification of injuries is necessary in order to develop a common language for treatment indications and outcomes. Several classification systems have been proposed, the most frequently used is the Denis classification. The problem of this classification system is that it is based on an assumption, which is anatomically unidentifiable: the so-called middle column. For this reason, few years ago, a group of spine surgeons has developed a new classification system, which is based on the severity of the injury. The severity is defined by the pathomorphological findings, the prognosis in terms of healing and potential of neurological damage. This classification is based on three major groups: A = isolated anterior column injuries by axial compression, B = disruption of the posterior ligament complex by distraction posteriorly, and group C = corresponding to group B but with rotation. There is an increasing severity from A to C, and within each group, the severity usually increases within the subgroups from .1, .2, .3. All these pathomorphologies are supported by a mechanism of injury, which is responsible for the extent of the injury. The type of injury with its groups and subgroups is able to suggest the treatment modality.
为了制定治疗指征和结果的通用语言，有必要对损伤进行分类。已经提出了几种分类系统，最常用的是 Denis 分类。该分类系统的问题在于它基于一种假设，即解剖上无法识别的所谓中柱。出于这个原因，几年前，一组脊柱外科医生开发了一种新的分类系统，该系统基于损伤的严重程度。严重程度是根据病理形态学发现、愈合的预后和潜在神经损伤来定义的。该分类基于三个主要组：A = 轴向压缩引起的单纯前柱损伤，B = 后向伸展引起的后韧带复合体破裂，C 组 = 与 B 组对应，但伴有旋转。从 A 到 C 严重程度逐渐增加，在每个组内，严重程度通常在.1、.2、.3 等亚组内增加。所有这些病理形态学都有损伤机制支持，该机制负责损伤的程度。损伤类型及其组和亚组能够提示治疗方式。
