[Thoracolumbar spine fractures : Classification and stability].

BACKGROUND

Fractures of the thoracolumbar spine are among the most common spinal injuries and are associated with a high risk of instability and neurological deficits. Accurate classification is crucial to correctly assess the severity of injury and initiate the correct treatment.

OBJECTIVES

Presentation and classification of current classification systems, in particular the AO Spine classification, for the structured analysis of thoracolumbar spine fractures, taking into account fracture morphology, ligament stability, and neurological status.

METHODS

Literature-based evaluation of epidemiological data, biomechanical principles and imaging techniques. Comparison of the Denis, Magerl, and AO Spine classifications and analysis of the role of computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosis.

RESULTS

The incidence of thoracolumbar fractures has increased significantly in recent years, especially in older patients. The Denis three-pillar model serves as a basis for assessing stability. The AO Spine classification offers a comprehensive, practical system that takes into account fracture morphology (type A-C), neurological status (N0-N4/NX), and patient-specific modifiers (M1/M2). CT is the method of choice for the detection of bony injuries, while MRI is indicated for the assessment of the spinal cord and ligaments in cases of neurological deficits.

CONCLUSION

The AO Spine classification facilitates standardized communication and supports well-founded treatment decisions by incorporating relevant clinical parameters. CT and MRI are indispensable for precise diagnosis. Nevertheless, the individual assessment of each patient, including relevant comorbidities, remains central to choosing optimal treatment and avoiding long-term complications.