Burst fractures of the thoracolumbar spine (Part I): literature review

Vladimir A. Radchenko, Konstantin A. Popsuyshapka, Yuriy A. Babalyan, Sergii A. Teslenko


Current approach to the diagnosis, classification and prediction of the course of burst fractures of the thoracolumbar spine takes into account primarily the morphology and mechanical origin of the damage. The timing of surgical care depends on the general condition of the patient and his neurological status. It is also very important to take into account the history of the disease, namely whether movements were stored in the limbs right after the injury. In our opinion, this is a very important sign of the further course of the disease. Given a large range of classifications in our work we focus on the classification of F. Magler, and we use Denis F. classification in the McCormack T. version when choosing tactics for surgical intervention. The existing surgical classification is quite perfect, but it does not take into account the presence of neurological symptoms, but only the possibility of kyphotic deformation, without considering the possible rotational displacements. The gaining new knowledge in the field of biomechanics and morphology of burst vertebral fractures will improve the diagnosis and classification of damages.


thoracic spine; lumbar spine; burst fracture; diagnosis; classification; treatment


1. Radchenko VA, Korzh N.A. [Practice on stabilization of the thoracic and lumbar spine]. Kharkov: Prapor; 2001. Russian.

2. Aebi M, Arlet V, Webb J. AoSpine Manual: Principles and Techniques, Clinical Applications. Thieme; 2007.

3. Aebi M. Classification of thoracolumbar fractures and dislocations. Eur Spine J. 2010 Mar;19 Suppl 1:S2-7. [CrossRef] [PubMed] [PubMed Central]

4. Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi B, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L; AOSpine Spinal Cord Injury & Trauma Knowledge Forum. AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976). 2013 Nov 1;38(23):2028-37. [CrossRef] [PubMed]

5. Bцhler L. Die Technik der Knochenbruchbehandlung. Vienna: Wilhelm Maudrich Verlag; 1929. German.

6. Nicoll EA. Fractures of the dorso-lumbar spine. J Bone Joint Surg Br. 1949 Aug;31B(3):376-94. [PubMed]

7. Whitesides TE Jr. Traumatic kyphosis of the thoracolumbar spine. Clin Orthop Relat Res. 1977 Oct;(128):78-92. [CrossRef] [PubMed]

8. Holdsworth F. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Am. 1970 Dec;52(8):1534-51. [PubMed]

9. Louis K. Surgery of the spine. Berlin: Springer-Verlag; 1983.

10. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983 Nov-Dec;8(8):817-31. [CrossRef] [PubMed]

11. Denis F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop Relat Res. 1984 Oct;(189):65-76. [CrossRef] [PubMed]

12. Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J. 1994;3(4):184-201. [CrossRef] [PubMed]

13. Joaquim AF, Fernandes YB, Cavalcante RA, Fragoso RM, Honorato DC, Patel AA. Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma. Spine (Phila Pa 1976). 2011 Jan 1;36(1):33-6. [CrossRef] [PubMed]

14. Pishnamaz M, Curfs I, Balosu S, Willems P, van Hemert W, Pape HC, Kobbe P. Two-Nation Comparison of Classification and Treatment of Thoracolumbar Fractures: An Internet-Based Multicenter Study Among Spine Surgeons. Spine (Phila Pa 1976). 2015 Nov;40(22):1749-56. [CrossRef] [PubMed]

15. Kolinnz RD. [Diagnosis of nervous diseases]. Moscow: Medicine; 1986. Russian.

16. International Standards for Neurological Classification of Spinal Cord Injured [Internet]. American Spinal Injury Association; 1982 [modified 2015 November; cited 2017 August 11]. Available from:

17. White AA, Panjabi MM. Clinical Biomechanics of the Spine. New York: Lippincott; 1990.

18. Kassar-Pullichino VN, Imhof H. [Spinal trauma in the light of diagnostic images]. Moscow: MEDpress-inform; 2009. Russian.

19. Lee JY, Vaccaro AR, Lim MR, Oner FC, Hulbert RJ, Hedlund R, Fehlings MG, Arnold P, Harrop J, Bono CM, Anderson PA, Anderson DG, Harris MB, Brown AK, Stock GH, Baron EM. Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma. J Orthop Sci. 2005 Nov;10(6):671-5. [PubMed] [PubMed Central]

20. Vaccaro AR, Rihn JA, Saravanja D, Anderson DG, Hilibrand AS, Albert TJ, Fehlings MG, Morrison W, Flanders AE, France JC, Arnold P, Anderson PA, Friel B, Malfair D, Street J, Kwon B, Paquette S, Boyd M, Dvorak MF, Fisher C. Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging. Spine (Phila Pa 1976). 2009 Nov 1;34(23):E841-7. [CrossRef] [PubMed]

21. Dai LY, Jin WJ. Interobserver and intraobserver reliability in the load sharing classification of the assessment of thoracolumbar burst fractures. Spine (Phila Pa 1976). 2005 Feb 1;30(3):354-8. [CrossRef] [PubMed]

22. McCormack T, Karaikovic E, Gaines RW. The load sharing classification of spine fractures. Spine (Phila Pa 1976). 1994 Aug 1;19(15):1741-4. [CrossRef] [PubMed]

23. Dai LY, Jiang LS, Jiang SD. Conservative treatment of thoracolumbar burst fractures: a long-term follow-up results with special reference to the load sharing classification. Spine (Phila Pa 1976). 2008 Nov 1;33(23):2536-44. [CrossRef] [PubMed]

GOST Style Citations

Copyright (c) 2017 Vladimir A. Radchenko, Konstantin A. Popsuyshapka, Yuriy A. Babalyan, Sergii A. Teslenko

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.