title: Posterior ligamentous complex injuries are related to fracture severity and neurological damage in patients with acute thoracic and lumbar burst fractures.
abstract: OBJECTIVE
  The proposed the thoracolumbar injury classification system (TLICS) for thoracolumbar injury cites the integrity of the posterior ligamentous complex (PLC). However, no report has elucidated the severity of damage in thoracic and lumbar injury with classification schemes by presence of the PLC injury. The purpose of this study was to accurately assess the severity of damage in thoracic and lumbar burst fractures with the PLC injuries.
  
  
  METHODS
  One hundred consecutive patients treated surgically for thoracic and lumbar burst fractures were enrolled in this study. There were 71 men and 29 women whose mean age was 36 years. Clinical and radiologic data were investigated, and the thoracolumbar injury classification schemes were also evaluated. All patients were divided into two groups (the P group with PLC injuries and the C group without PLC injuries) for comparative examination.
  
  
  RESULTS
  Fourth-one of 100 cases showed PLC injuries in MRI study. The load sharing classification score was significantly higher in the P group [7.8±0.2 points for the P group and 6.9±1.1 points for the C group (p<0.001)]. The TLICS (excluded PLC score) score was also significantly higher in the P group [6.2±1.1 points for the P group and 4.0±1.4 points for the C group (p<0.001)].
  
  
  CONCLUSIONS
  The presence of PLC injury significantly influenced the severity of damage. In management of thoracic lumbar burst fractures, evaluation of PLC injury is important to accurately assess the severity of damage.
authors.affiliation: Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, 1-10-6 Komei, Minato-ku, Nagoya, Aichi 455-8530, Japan. masaaki_machino_5445_2@yahoo.co.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Machino
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Yukawa
authors.forename: Keigo
authors.initials: K
authors.lastname: Ito
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kanbara
authors.forename: Daigo
authors.initials: D
authors.lastname: Morita
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries*; D008159:Lumbar Vertebrae / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000145:classification* / Q000503:physiopathology* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000293:injuries*; D055815:Young Adult
keywords: Burst fracture; posterior ligamentous complex injury; thoracic and lumbar spine