Rationale for the management of flexion-distraction injuries of the thoracolumbar spine based on a new classification.

A new classification of flexion-distraction injuries of the spine is described based on the bony and soft tissue injuries to the posterior complex and the anterior column. In addition, the classification includes the status of the vertebral body, that is, the association of a wedge-compression fracture or a burst injury. The soft tissue component provides a rationale for surgical intervention. Most injuries were treated by compression instrumentation, but it is recommended that those injuries associated with a burst component require distraction instrumentation.