Denis F
Clin Orthop Relat Res. 1984 Oct(189):65-76.
This article is a presentation of the concept of the three-column spine. The concept evolved from a retrospective review of 412 thoracolumbar spine injuries and observations on spinal instability. The posterior column consists of what Holdsworth described as the posterior ligamentous complex. The middle column includes the posterior longitudinal ligament, posterior annulus fibrosus, and posterior wall of the vertebral body. The anterior column consists of the anterior vertebral body, anterior annulus fibrosus, and anterior longitudinal ligament. Major spinal injuries are classified into four different categories, all definable in terms of the degree of involvement of each of the three columns. Each type is defined also in terms of its pathomechanics, roentgenograms, and computerized axial tomograms, as well as in terms of its particular stability. The compression fracture is basically stress failure of the anterior column with an intact middle column. The burst fracture indicates failure under compression of both the anterior and middle columns. The seat-belt-type spinal fracture is the result of failure of the posterior and middle columns under tension with an intact anterior hinge. In fracture-dislocations, the structure of all three columns fails from forces acting to various degrees from one or another direction.
本文介绍了脊柱三柱概念。该概念源于对412例胸腰椎损伤的回顾性研究以及对脊柱不稳定的观察。后柱由霍尔兹沃思所描述的后韧带复合体组成。中柱包括后纵韧带、纤维环后部和椎体后壁。前柱由椎体前部、纤维环前部和前纵韧带组成。主要的脊柱损伤分为四类，所有这些损伤都可以根据三柱中每柱的受累程度来定义。每种类型还根据其病理力学、X线片、计算机断层扫描以及其特定的稳定性来定义。压缩性骨折基本上是前柱的应力性破坏，中柱完整。爆裂性骨折表明前柱和中柱在压缩下均发生破坏。安全带型脊柱骨折是后柱和中柱在张力作用下破坏的结果，前铰链完整。在骨折脱位中，所有三柱的结构因来自一个或另一个方向的不同程度的作用力而破坏。
