This international consensus study introduces the AOSpine thoracolumbar injury classification. It asks whether a simple, CT-based morphologic scheme can describe these fractures reliably while adding neurological status and clinical modifiers. Forty cases were graded twice by 9 spine surgeons to measure agreement.
When you read a thoracolumbar CT, anchor on the column that failed. Anterior compression with an intact posterior tension band is type A. Add a tension band injury and it becomes type B. Add translation and it is type C.
The practical pivot is the posterior wall and the tension band. An A1 wedge is stable. An A3 or A4 burst involves the posterior wall but keeps the tension band intact. The moment the PLC is disrupted, the same burst becomes a B2 and the surgical conversation changes.
This system was designed to replace Denis and the more complex Magerl scheme as the modern common language for spine trauma. It deliberately runs on CT so it works at any trauma center, reserving MRI and the M1 modifier for when PLC integrity is genuinely uncertain.
For boards, memorize the A0-A4, B1-B3, C structure, the N0-NX neurological grades, and the M1/M2 modifiers. Note that this paper validated reliability only and explicitly did not finalize a surgical scoring threshold.
This international consensus study introduces the AOSpine thoracolumbar injury classification. It asks whether a simple, CT-based morphologic scheme can describe these fractures reliably while adding neurological status and clinical modifiers. Forty cases were graded twice by 9 spine surgeons to measure agreement.
When you read a thoracolumbar CT, anchor on the column that failed. Anterior compression with an intact posterior tension band is type A. Add a tension band injury and it becomes type B. Add translation and it is type C.
The practical pivot is the posterior wall and the tension band. An A1 wedge is stable. An A3 or A4 burst involves the posterior wall but keeps the tension band intact. The moment the PLC is disrupted, the same burst becomes a B2 and the surgical conversation changes.
This system was designed to replace Denis and the more complex Magerl scheme as the modern common language for spine trauma. It deliberately runs on CT so it works at any trauma center, reserving MRI and the M1 modifier for when PLC integrity is genuinely uncertain.
For boards, memorize the A0-A4, B1-B3, C structure, the N0-NX neurological grades, and the M1/M2 modifiers. Note that this paper validated reliability only and explicitly did not finalize a surgical scoring threshold.