Magerl and colleagues set out to build a comprehensive, mechanism‑based classification of thoracic and lumbar injuries in which an injury's rank expresses its degree of instability.
Classification proposal built on more than a decade of work and a review of 1445 consecutive thoracolumbar injuries.
Methods
Design
Classification proposal
Review of consecutive cases
Patients
1445 consecutive thoracolumbar injuries
1212 patients evaluated for neurological deficit
468 cases analyzed in more detail
Basis
Pathomorphology
Main mechanism of injury
Prognosis for healing
AO 3‑3-3 grid of types, groups and subgroups
Key Findings
Neurological deficit rose significantly with each type: 14% in type A, 32% in type B and 55% in type C, for 22% overall among 1212 patients evaluated.
Type A injuries made up 66.1% of the 1445 cases, vs 19.4% for type C and 14.5% for type B.
Stable A1 fractures alone accounted for 34.7% of all injuries.
Within type A, 32% of the 344 A3 burst fractures had a deficit, vs 2% of A1 and 4% of A2 fractures.
Injuries clustered around the thoracolumbar junction, with L1 (402 cases) and T12 (246) the most often injured levels.
Multisegmental thoracolumbar injuries were present in 23% of the 468 cases analyzed in detail.
Board pearl
In the Magerl (AO) system, severity rises not only from type A to C but also through the groups and subgroups within each type.
Magerl and colleagues set out to build a comprehensive, mechanism‑based classification of thoracic and lumbar injuries in which an injury's rank expresses its degree of instability.
Classification proposal built on more than a decade of work and a review of 1445 consecutive thoracolumbar injuries.
Methods
Design
Classification proposal
Review of consecutive cases
Patients
1445 consecutive thoracolumbar injuries
1212 patients evaluated for neurological deficit
468 cases analyzed in more detail
Basis
Pathomorphology
Main mechanism of injury
Prognosis for healing
AO 3‑3-3 grid of types, groups and subgroups
Key Findings
Neurological deficit rose significantly with each type: 14% in type A, 32% in type B and 55% in type C, for 22% overall among 1212 patients evaluated.
Type A injuries made up 66.1% of the 1445 cases, vs 19.4% for type C and 14.5% for type B.
Stable A1 fractures alone accounted for 34.7% of all injuries.
Within type A, 32% of the 344 A3 burst fractures had a deficit, vs 2% of A1 and 4% of A2 fractures.
Injuries clustered around the thoracolumbar junction, with L1 (402 cases) and T12 (246) the most often injured levels.
Multisegmental thoracolumbar injuries were present in 23% of the 468 cases analyzed in detail.
Board pearl
In the Magerl (AO) system, severity rises not only from type A to C but also through the groups and subgroups within each type.