P.: The Value of Computed Tomography in Thoracolumbar Fractures. An Analysis of One Hundred Consecutive Cases and a New Classification

ABSTRACT: We studied 100 consecutive patients with potentially unstable fractures and fracture-dislocations by multiplane computed tomography. The mechanism of failure of the middle osteoligamentous complex of the spine (posterior longitudinal ligament, posterior part of the vertebral body, and posterior an-nulus fibrosus) was determined by three-dimensional analysis. Three modes of middle-column failure were used to classify the injuries: axial compression (seventy-three patients), axial distraction (fifteen pa-tients), and translation within the transverse plane (twelve patients). Fifty of eighty-six patients who were evaluated in the acute phase of injury underwent operative stabilization, and the mechanism of middle-column disruption determined the type of instrumen