A new system of classification for spinal injuries.
BACKGROUND
A comprehensive classification for spinal trauma has proved difficult to achieve as attested to by the number of systems in use today. In addition, few systems can be applied to all levels of the spine, and the first two cervical vertebrae are usually treated as altogether separate from the remainder of the spine. Consequently, outcome data and comparison of published data are difficult, at best.


OBJECTIVE
The purpose of this presentation is to introduce a new system for classification of spine trauma applicable to all levels of the spine.


METHODS
A different way of viewing the vertebrae is proposed. It allows the inclusion of all levels of the spinal column in a unified classification system based on the morphology of the injury. Each vertebra is viewed as a bony ring, and the rings are linked, above and below, by three osseoligamentous structures. These are the end plate-disc-end plate anteriorly and the facet joints posteriorly. Equivalent structures for the links are defined for the atlas and axis.


METHODS
The x-rays and computed tomographic or magnetic resonance imaging of patients with spine trauma were used to apply this classification to acute injuries. The sample used was all patients with spine trauma admitted, during a 1-year period, to a level 1 trauma center. Not all the patients were treated by the author, and no attempt was made to determine indications for treatment or treatment outcomes on the basis of this new classification system.


METHODS
A new classification retrospectively applied to a defined patient population, which appeared to be representative of known trauma patterns.


RESULTS
All patients with spinal trauma in this patient population were classifiable by this new system. All fracture types proposed in this system were represented in the patient sample.


CONCLUSIONS
This new classification system appears to warrant further study.
Department of Orthopaedic Surgery, University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School, 1527 Highway 27, Somerset, NJ 08873, USA.
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Malberg
D002574:Cervical Vertebrae / Q000293:injuries; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries; D016103:Spinal Fractures / Q000145:classification* / Q000175:diagnosis; D013904:Thoracic Vertebrae / Q000293:injuries