AO Spine classification of thoracolumbar injuries
Updates to Article Attributes
Title
was changed:
AO thoracolumbar fractures classificationclassification of spinal injuries
Body
was changed:
The Arbeitsgemeinschaft für Osteosynthesefragen (AO) classificationof spinal injuries aims to simplify and universalise the process of classifying spinal injuries. This system consists of only three classes of thoracolumbar injuries. The AO classification does not currently predict treatment unlike the thoracolumbar injury classification and severity score (TLICS) 1.
Classification
-
Morphologymorphology of the fracture -
Presencepresence of neurological signs -
Presencepresence of ligamentous injuries or co-morbid conditions( referred(referred to as modifiers)
Grading of injuries
Injuries are broadly categorised into three groups:
- A:
Compressioncompression injuries - B:
Distractiondistraction injuries - C:
Displacementdisplacement or dislocationThe following subcategories exist:
A: Compressioncompression injuries
Type A injuries involve the anterior portion of the vertebral column with an intact posterior tension band (group(the group of muscles, ligaments and processes/pedicles that maintain the integrity of the vertebral column):
- A0:
No - A1:
Alsoalso known as wedge compression injuries. They; they involve a single anterior or middle endplate of the vertebral body without the involvement of the posterior aspect of the posterior vertebral wall. - A2:
Alsoalso known as split or pincer type injuries. They; they involve both endplates without the involvement of the posterior wall. - A3:
Alsoalso known as incomplete burst injuries. They; they involve a single end plate along with the posterior vertebral wall. Vertebral; a vertebral laminar fracture is usually also present. - A4:
Alsoalso known as complete burst injuries. They; they involve both end plates along with the posterior vertebral wall and are also often associated with a laminar fracture.
B: Distractiondistraction injuries
Type B injuries involve the anterior or posterior tension band. :
- B1:
Alsoalso known aschanceChance fractures. They; they involve disruption of the posterior tension band with extension into the vertebral body - B2:
Alsoalso known as posterior tension band disruption injuries. Involvement; involvement of an intervertebral body level with disruption to the posterior +/- anterior tension band. - B3:
Alsoalso known as hyperextension injuries. They; they involve injuries to the anterior tension band +/- intervertebral or interosseous injury.
C: Translationtranslation injuries
Type C injuries involve displacement in any direction. No subtypes are present as there are numerous possibilities of dislocating fractures.
Presence of neurological signs
- N0: no focal neurological signs present
- N1: history of transient neurological signs
- N2: current symptoms of radiculopathy
- N3: incomplete spinal cord or caudal equina injury
- N4: complete spinal cord injury (complete absence of motor and sensory function) 2
) - NX: cannot be assessed
Presence of modifiers
- M1:
Presencepresence of ligamentous injury in the absence of vertebral body injury which can contribute to poor stability - M2:
Presencepresence of co-morbid conditionslikesuch as ankylosing spondylitis,osteopenia orosteopaenia, osteoporosis, overlying burns, etc.
-<p>The Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification of spinal injuries aims to simplify and universalise the process of classifying spinal injuries. This system consists of only three classes of thoracolumbar injuries. The AO classification does not currently predict treatment unlike the <a title="Thoracolumbar injury classification and severity score (TLICS)" href="/articles/thoracolumbar-injury-classification-and-severity-score-tlics-1">thoracolumbar injury classification and severity score (TLICS)</a> <sup>1</sup>. </p><h4>Classification</h4><ul>-<li>Morphology of the fracture</li>-<li>Presence of neurological signs</li>-<li>Presence of ligamentous injuries or co-morbid conditions ( referred to as modifiers)</li>-</ul><h4>Grading of injuries</h4><p>Injuries are broadly categorised into three groups: </p><p>A: Compression injuries<br>B: Distraction injuries<br>C: Displacement or dislocation</p><p>The following subcategories exist: </p><h5>A: Compression injuries</h5><p>Type A injuries involve the anterior portion of the vertebral column with an intact posterior tension band (group of muscles, ligaments and processes/pedicles that maintain the integrity of the vertebral column)</p><p>A0: <strong>No</strong> or <strong>clinically insignificant fractures</strong> of the spinous or transverse processes<br>A1: Also known as wedge compression injuries. They involve a <strong>single anterior or middle endplate</strong> of the vertebral body without involvement of the posterior aspect of the posterior vertebral wall. <br>A2: Also known as split or pincer type injuries. They involve <strong>both endplates</strong> without involvement of the posterior wall.<br>A3: Also known as incomplete burst injuries. They involve a <strong>single end plate along with the posterior vertebral wall</strong>. Vertebral laminar fracture is usually also present. <br>A4: Also known as complete burst injuries. They involve <strong>both end plates along with the posterior vertebral wall</strong> and are also often associated with a laminar fracture. </p><h5>B: Distraction injuries</h5><p>Type B injuries involve the anterior or posterior tension band. </p><p>B1: Also known as chance fractures. They involve disruption of the <strong>posterior tension band</strong> with <strong>extension into the vertebral body</strong><br>B2: Also known as posterior tension band disruption injuries. Involvement of an <strong>intervertebral body</strong> level with disruption to the posterior +/- anterior tension band. <br>B3: Also known as hyperextension injuries. They involve injuries to the <strong>anterior tension band</strong> +/- intervertebral or interosseous injury. </p><h5>C: Translation injuries</h5><p>Type C injuries involve <strong>displacement</strong> in any direction. No subtypes are present as there are numerous possibilities of dislocating fractures. </p><h5>Presence of neurological signs</h5><p>N0: no focal neurological signs present<br>N1: history of transient neurological signs<br>N2: current symptoms of radiculopathy<br>N3: incomplete spinal cord or caudal equina injury<br>N4: complete spinal cord injury (complete absence of motor and sensory function <sup>2</sup>)<br>NX: cannot be assessed</p><h5>Presence of modifiers</h5><p>M1: Presence of ligamentous injury in the absence of vertebral body injury which can contribute to poor stability<br>M2: Presence of co-morbid conditions like ankylosing spondylitis, osteopenia or osteoporosis, overlying burns etc. </p>- +<p>The <strong>Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification</strong> <strong>of spinal injuries</strong> aims to simplify and universalise the process of classifying spinal injuries. This system consists of only three classes of thoracolumbar injuries. The AO classification does not currently predict treatment unlike the <a href="/articles/thoracolumbar-injury-classification-and-severity-score-tlics-1">thoracolumbar injury classification and severity score (TLICS)</a> <sup>1</sup>. </p><h4>Classification</h4><ul>
- +<li>morphology of the fracture</li>
- +<li>presence of neurological signs</li>
- +<li>presence of ligamentous injuries or co-morbid conditions (referred to as modifiers)</li>
- +</ul><h4>Grading of injuries</h4><p>Injuries are broadly categorised into three groups: </p><ul>
- +<li>A: compression injuries</li>
- +<li>B: distraction injuries</li>
- +<li>C: displacement or dislocation</li>
- +</ul><h5>A: compression injuries</h5><p>Type A injuries involve the anterior portion of the vertebral column with an intact posterior tension band (the group of muscles, ligaments and processes/pedicles that maintain the integrity of the vertebral column):</p><ul>
- +<li>A0: no or clinically insignificant fractures of the spinous or transverse processes</li>
- +<li>A1: also known as wedge compression injuries; they involve a single anterior or middle endplate of the vertebral body without the involvement of the posterior aspect of the posterior vertebral wall</li>
- +<li>A2: also known as split or pincer type injuries; they involve both endplates without the involvement of the posterior wall</li>
- +<li>A3: also known as incomplete burst injuries; they involve a single end plate along with the posterior vertebral wall; a vertebral laminar fracture is usually also present</li>
- +<li>A4: also known as complete burst injuries; they involve both end plates along with the posterior vertebral wall and are also often associated with a laminar fracture</li>
- +</ul><h5>B: distraction injuries</h5><p>Type B injuries involve the anterior or posterior tension band:</p><ul>
- +<li>B1: also known as <a title="Chance fractures" href="/articles/chance-fracture">Chance fractures</a>; they involve disruption of the posterior tension band with extension into the vertebral body</li>
- +<li>B2: also known as posterior tension band disruption injuries; involvement of an intervertebral body level with disruption to the posterior +/- anterior tension band</li>
- +<li>B3: also known as hyperextension injuries; they involve injuries to the <strong>anterior tension band</strong> +/- intervertebral or interosseous injury</li>
- +</ul><h5>C: translation injuries</h5><p>Type C injuries involve <strong>displacement</strong> in any direction. No subtypes are present as there are numerous possibilities of dislocating fractures. </p><h5>Presence of neurological signs</h5><ul>
- +<li>N0: no focal neurological signs present</li>
- +<li>N1: history of transient neurological signs</li>
- +<li>N2: current symptoms of radiculopathy</li>
- +<li>N3: incomplete <a title="Spinal cord injury" href="/articles/spinal-cord-injury">spinal cord</a> or caudal equina injury</li>
- +<li>N4: complete spinal cord injury (complete absence of motor and sensory function) <sup>2</sup>
- +</li>
- +<li>NX: cannot be assessed</li>
- +</ul><h5>Presence of modifiers</h5><ul>
- +<li>M1: presence of ligamentous injury in the absence of vertebral body injury which can contribute to poor stability</li>
- +<li>M2: presence of co-morbid conditions such as <a title="Ankylosing spondylitis" href="/articles/ankylosing-spondylitis">ankylosing spondylitis</a>, <a title="osteopaenia" href="/articles/osteopaenia">osteopaenia</a>, <a title="Osteoporosis" href="/articles/osteoporosis-3">osteoporosis</a>, overlying burns, etc</li>
- +</ul>
Tags changed:
- cases
- refs
Systems changed:
- Trauma
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