Thracia and Lumbar Fracture: Classification According to Three Column Theory and its Relationship to Paralysis

Kim, K. H.; Cho, J. L.; Kim, T. S.; Choi, K. H.

Abstract

We reviewed 217 patients (270 cases) of thoracic and lumbar fractures and fracture-dislocations, who were treated at Hanyang University Hospital from January, 1977 to December, 1985. We classified spinal injuries according to three column theory and then analyzed the cause of injury, sex-age distribution, treatment and neurological injuries. The results were as follows: 1. The cases were classified into 4 different categories according to the three column theory; compression fractures (191 cases, 70.7%), burst fractures (54 cases, 20.0%), fracture-dislocations(22 cases, 8.2%), and seat belt type injuries (3 cases, 1.1%). And each of these 4 different categories was then subdivided into subtypes. 2. The most common cause of injury was fall from a height (45.2 %). 3. The neurological injuries were occurred in 21 patients (9.7%). The 16 patients with neural deficit in fracture-dislocation, 15 patients were flexion rotation type. The 5 patients with neural deficit in burst fracture, all were incomplete neural deficits. 4. The greatest advantage of Luque instrumentation was an early rehabilitation without external surport.