Classification of thoracolumbar spine fractures

1, Simple Deeded Compression Fracture: This is the result of an injury to the anterior column of the spine. The violence comes from the force of rotation along the X-axis, causing the spine to flex forward, with the posterior structures less affected and the vertebrae usually in a chevron shape. This type of fracture does not damage the middle column and the spine retains its zonal stability. This type of fracture is usually the result of a fall from height injury, foot or hip landing, and violent body flexion, which produces compression of the anterior half of the vertebral body. 2. Stability blast fracture: This is the result of injury to the anterior and middle columns of the spine. The violence comes from axial compression of the Y-axis. In a fall from height injury, the foot and hip land, the spine remains straight, the vertebral body of the thoracolumbar segment of the spine is subjected to the greatest force and shattered due to extrusion, as there is no rotational force, the posterior column of the spine is unaffected, thus still retaining the stability of the spine, but the broken vertebral body and disc can protrude in front of the spinal canal, injuring the spinal cord and producing neurological symptoms. 3. Instability blast fracture: This is the result of simultaneous injury to the anterior, middle and posterior columns. The violence comes from the axial compression of the Y-axis and clockwise rotation, and there may be rotational forces along the Z-axis involved, so that the posterior column is also fractured, and due to the instability of the spine, post-traumatic posterior spinal protrusion and progressive neurological symptoms may occur. 4.Chaece fracture: It is a vertebral body level laceration injury. In the past, it was thought that the violence came from the maximum force of rotation along the X-axis, so that the spine was overextended and the injury occurred, for example, falling from a height on the back, the back was blocked by objects when landing, so that the spine was overextended, the anterior longitudinal ligament was ruptured, the vertebral body was transversely split, and the spinous processes were extruded from each other and fractured, and the last vertebral body could be displaced backward. This fracture is also considered to be a consequence of flexion of the spine, and the axis of flexion should be in front of the anterior longitudinal ligament, so it is considered to be the result of axial pulling of the spine from the Y-axis, as well as the participation of rotational forces along the X-axis, which is also an instability fracture. 5. Flexion-distraction type injury: the flexion axis is posterior to the anterior longitudinal ligament, and the anterior column is partially injured by the compression force, while the middle and posterior columns are injured by the tension force of distraction, while the middle and posterior columns are injured by the tension force of distraction, and the middle and posterior columns are partially injured by the tension force of distraction, and the middle column is partially injured by the rupture of the vertebral joint capsule, dislocation of the articular eminence, subluxation or fracture, and this injury often also has the involvement of rotational force from the Y-axis, so this type of injury is often Potentially unstable fractures due to tears in the ligamentum flavum, interspinous ligament and supraspinous ligament. 6. Spinal fracture-dislocation: also known as a mobility injury. Violence from the Z axis, such as a car accident violence directly from the back of the back impact, or bending work, heavy objects falling from height directly hit the back, under the action of strong violence, the alignment of the vertebral canal has been completely broken, in the plane of injury, the vertebrae along the transverse plane of displacement, usually all three columns are destroyed by shear, the plane of injury is usually through the intervertebral disc, and also the participation of rotational forces, so the degree of dislocation is heavier than fracture When the articular eminence is completely dislocated, the lower articular eminence moves to the front of the upper articular eminence of the next vertebra, blocking each other, called articular eminence interlocking, which is extremely serious spinal injury is inevitable and has a poor prognosis. There are also some simple accessory fractures such as vertebral plate fractures with yellow protrusion fractures, which do not weigh down the instability of the spine, called stable fractures, especially transverse process fractures, which are often avulsion fractures resulting from violent contraction of the lumbar muscles after an impact on the back.