Classification and Radiological Diagnosis of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Abstract

The aim of this review to determine recommendations for classification and radiological diagnosis of thoracolumbar spine fractures. Recommendation was made through a literature review of the last 10 years. The statements created by the authors were discussed and voted on during 2 consensus meetings organized by the WFNS (World Federation Neurosurgical Societies) Spine Committee. The literature review was yielded 256 abstracts, of which 32 were chosen for full-text analysis. Thirteen papers evaluated the reliability of a classification system by our expert members and were also chosen in this guideline analysis. This literature review-based recommendation provides the classification and radiologic diagnosis in thoracolumbar spine fractures that can elucidate the management decision-making in clinical practice.

Keywords: Classifications; Radiological diagnosis; Therapy recommendation; Thoracolumbar spine fracture.

Fig. 1.

Flowchart of the literature search we used.

Fig. 2.

Measurements used in the calculation of anterior vertebral body height loss. Measure from the lateral x-ray film the height of the most anterior corpus vertebra (straight line): (A) the height of normal superior vertebra; (B) the height of the fractured vertebral body; (C) the height of the normal inferior vertebra. Reprinted from Ruiz Santiago et al., Quant Imaging Med Surg 2016;6:772-84 [35].

Fig. 3.

Measurements used in the calculation of interspinous distance in anterorposterior x-ray film, Make a horizontal straight line right on the upper edge of each spinous process, then the distance between the adjacent horizontal lines is the interspinous process distance: (A) Interspinous distance of normal superior vertebra; (B) Interspinous distance of a fractured vertebra; (C) Interspinous distance of normal inferior vertebra. Reprinted from Ruiz Santiago et al., Quant Imaging Med Surg 2016;6:772-84 [35].

Fig. 4.

Measurements used in the calculation of canal narrowing percent in axial computed tomography scan of the vertebral body. The ratio of each spinal canal is the division of the sagittal diameter (s) by the transverse diameter (t). (A) Canal ratio of the normal superior vertebra; (B) Canal ratio of the fractured vertebra; (C) Canal ratio of the normal inferior vertebra. Reprinted from Ruiz Santiago et al., Quant Imaging Med Surg 2016;6:772-84 [35].