Distribution and Patterns of Posterior Column Injury in Flexion-Distraction Injuries of Thoracolumbar Spine / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A retrospective analysis of the distribution and patterns of posterior column injury in flexion-distraction injuries of the thoracolumbar spine. OBJECTIVES: To recognize the various types of posterior column injury in terms of the path of the distraction force in flexion-dis-traction injuries of the thoracolumbar spine. SUMMARY OF LITERATURE REVIEW As posterior column injuries are associated with instability of the spine, many authors have described and classified posterior column injuries. However, there are no descriptions or classifications in terms of the path of the distraction force in the literature. MATERIALS AND METHOD: The preoperative plain X-rays, axial CT, MRI (in 5 patients) and operation records of 34 patients were reviewed in relation to the patterns of posterior column injury. RESULTS: Posterior column injuries can be classified into two main types. In Type I(30/34), the distraction failure started from the spinous process one level above the fractured body (Type IA) or the posterior ligament complex between the spinous processes of the fractured and the level above (Type IB). In Type II(4/34), the distraction failure started from the spinous process of the fractured vertebra and from the interspinous ligament between the fractured level and the level below. CONCLUSIONS: Posterior column injuries can be described according to their starting point and the extent of the distraction force. Of these, Type IB was the most common. Using this classification, the injury of the posterior column in injuries of the thora-columbar spine fracture can be predicted.