Spinal classification1

The experts recommendations used in FRACTURE SCOUT are limited to osteoporotic vertebral compression fracture type A documented with an appropriate imaging technique (MRI), having at least moderate symptoms (VAS≥5) correlating with the fracture in the absence of neurological symptoms.

Based on a review of 1445 consecutive thoracolumbar injuries, a comprehensive classification of thoracic and lumbar injuries was proposed by Margerl and colleagues. The classification is primarily based on pathomorphological criteria. Categories are established according to the main mechanism of injury, pathomorphological uniformity, and in consideration of prognostic aspects regarding healing potential. The classification reflects a progressive scale of morphological damage by which the degree of instability is determined. The severity of the injury in terms of instability is expressed by its ranking within the classification system. A simple grid, the 3-3-3 scheme of the AO fracture classification, was used in grouping the injuries.

This grid consists of three types:

  • Type A (vertebral body compression) focuses on injury patterns of the vertebral body.
  • Type B injuries (anterior and posterior element injuries with distraction) are characterized by transverse disruption either anteriorly or posteriorly.
  • Type C lesions (anterior and posterior element injuries with rotation) describe injury patterns resulting from axial torque.

Every type has three groups, each of which contains three subgroups with specifications. The types have a fundamental injury pattern which is determined by the three most important mechanisms acting on the spine: compression, distraction, and axial torque.

  1. F. Magerl, M. Aebi, SF. Magerl, M. Aebi, S. D. Gertzbein and al. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J (1994) 3 : 184-201.