Radiographic assessment of thoracolumbar fractures based on axial zones

Ali A. Baaj, Brian R. Gantwerker, Nicholas Theodore, Juan S. Uribe, Fernando Vale Diaz, Neil R. Crawford, Volker K H Sonntag

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

STUDY DESIGN: Retrospective study of computed tomography imaging of patients with thoracolumbar (TL) fractures. OBJECTIVE: To propose an axial model of spinal fractures based on the osteoligamentous continuity of the TL spinal segments in the axial plane and to determine the correlation between the 3-column theory and the proposed axial zone model. SUMMARY OF BACKGROUND DATA: Predicting spinal instability of TL fractures is based on several radiologic and clinical parameters. Efforts to refine fracture classification schemes to better predict instability continue. METHODS: Computed tomography scans of 229 consecutive patients who presented with TL fractures between March 2005 and April 2007 were reviewed. TL fractures were classified according to both the Denis 3-column theory and the proposed axial zone model. The incidence of column and axial zone injuries was determined. On the basis of these results, a treatment algorithm was developed. RESULTS: Zone disruption in surgical fractures was distributed as follows: 24 (96%) involved zone A, 25 (100%) involved zone B, 17 (68%) involved zone C, and 15 (60%) involved zone D. All surgical fractures involved 2 or more zones. Zone B was involved in all surgical fractures. The likelihood of surgical intervention increased as the number of zones increased, especially if the injury was a 2-column or 3-column injury. CONCLUSIONS: The current 3-column theory of spinal stability does not account for the axial component of an injury. Application of our proposed "axial zone model" may enhance the ability to predict stability, depending not only on the number of columns, but also on the number of zones involved in the injuries. Further clinical and biomechanical studies are warranted to validate this model.

Original languageEnglish (US)
Pages (from-to)59-63
Number of pages5
JournalJournal of Spinal Disorders and Techniques
Volume27
Issue number2
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Wounds and Injuries
Tomography
Spinal Fractures
Stress Fractures
Spine
Retrospective Studies
Incidence
Therapeutics
Clinical Studies

Keywords

  • classification
  • fractures
  • fusion
  • spine
  • thoracolumbar
  • trauma

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Baaj, A. A., Gantwerker, B. R., Theodore, N., Uribe, J. S., Vale Diaz, F., Crawford, N. R., & Sonntag, V. K. H. (2014). Radiographic assessment of thoracolumbar fractures based on axial zones. Journal of Spinal Disorders and Techniques, 27(2), 59-63. https://doi.org/10.1097/BSD.0b013e318250ebf0

Radiographic assessment of thoracolumbar fractures based on axial zones. / Baaj, Ali A.; Gantwerker, Brian R.; Theodore, Nicholas; Uribe, Juan S.; Vale Diaz, Fernando; Crawford, Neil R.; Sonntag, Volker K H.

In: Journal of Spinal Disorders and Techniques, Vol. 27, No. 2, 01.01.2014, p. 59-63.

Research output: Contribution to journalArticle

Baaj, AA, Gantwerker, BR, Theodore, N, Uribe, JS, Vale Diaz, F, Crawford, NR & Sonntag, VKH 2014, 'Radiographic assessment of thoracolumbar fractures based on axial zones', Journal of Spinal Disorders and Techniques, vol. 27, no. 2, pp. 59-63. https://doi.org/10.1097/BSD.0b013e318250ebf0
Baaj, Ali A. ; Gantwerker, Brian R. ; Theodore, Nicholas ; Uribe, Juan S. ; Vale Diaz, Fernando ; Crawford, Neil R. ; Sonntag, Volker K H. / Radiographic assessment of thoracolumbar fractures based on axial zones. In: Journal of Spinal Disorders and Techniques. 2014 ; Vol. 27, No. 2. pp. 59-63.
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AU - Crawford, Neil R.

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