胸腰椎骨折——AO分型

该分类和损伤严重程度系统是基于三个基本参数评估:

（This classification and injury severity system is based on the evaluation of three basic parameters:）

1. Morphologic classification of the fracture（骨折的形态学分类）

2. Neurologic injury（神经损伤）

3. Clinical modifiers（临床修正参数）

---

First. Morphologic classification

这是基于Magerl分类修改后的AOSpine分类。对于这种分类，x线片和CT多平面重建扫描是必不可少的。在某些情况下，可能需要额外的MR图像。

• Type A: Compression injuries. Failure of anterior structures under compression

• Type B: Failure of the posterior or anterior tension band.

• Type C: Failure of all elements leading to dislocation or displacem

---

胸腰椎骨折分类的诊断法则（Diagnostic algorithm for the classification of TL injuries）

---

Type A

A0.Minor, nonstructural fractures 

• Fractures, which do not compromise the structural integrity of the spinal column such as transverse process or spinous process fractures

---

A1. Wedge-compression

• Fracture of a single endplate without involvement of the posterior wall of the vertebral body.

---

A2. Split

• Fracture of both endplates without involvement of the posterior wall of the vertebral body.

---

A3. Incomplete burst

• Fracture with any involvement of the posterior wall; only a single endplate fractured.

• Vertical fracture of the lamina is usually present and does not constitute a tension band failure.

---

A4. Complete burst

• Fracture with any involvement of the posterior wall and both endplates.

• Vertical fracture of the lamina is usually present and does not constitute a tension band failure.

---

Type B

B1. Transosseous tension band disruption/Chance fracture

• Monosegmental pure osseous failure of the posterior tension band.

• The classical Chance fracture.

---

B2. Posterior tension band disruption

• Bony and/or ligamentary failure of the posterior tension band together with a Type A fracture.

• Type A fracture should be classified separately

---

B3.Hyperextension

• Injury through the disk or vertebral body leading to a hyperextended position of the spinal column.

• Commonly seen in ankylotic disorders. Anterior structures, especially the ALL are ruptured but there is a posterior hinge preventing further displacement.

Type C

C. Displacement or dislocation

• There are no subtypes as because of the dissociation between cranial and caudal segments various configurations are possible in different images.

• Is combined with subtypes of A if necessary

---

Second.Neurologic injury

Neurologic status at the moment of admission should be scored according to the following scheme:

---

Third. Modifiers

---

特别说明：

以上知识仅代表个人认识程度，非标准意见！！！

如有不当之处，还望指出，诚谢！

---

知识

在于传播、交流、分享

学习之余，把它分享给更多的人

学习我们是认真的！

投稿请扔至[e-mail]

---

来源文献：

1. Vaccaro, A. R., C. Oner, C. K. Kepler, M. Dvorak, K. Schnake, C. Bellabarba, M. Reinhold, B. Aarabi, F. Kandziora, J. Chapman, R. Shanmuganathan, M. Fehlings, L. Vialle, A. O. S. C. Injury and F. Trauma Knowledge (2013). “AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers.” Spine (Phila Pa 1976) 38(23): 2028-2037.

2. Kepler, C. K., A. R. Vaccaro, J. D. Koerner, M. Dvorak, F. Kandziora, S. Rajasekaran, L. Vialle, M. Fehlings, G. D. Schroeder, M. Reinhold, K. Schnake, C. Bellabarba and C. Oner (2015). “Reliability Analysis of the AOSpine thoracolumbar Spine Injury Classification System by a Worldwide Group of Naïve Spinal Surgeouns.” European Spine Journal. (in press)

3. Submitted to AOSpine International Board for endorsement as the official AOSpine TL Fractures Classification。