Cemil AKTAN

Vertebral Compression Fractures (VCFs)

Spine Trauma Classifications

Early systems such as Denis’ three-column model and Allen–Ferguson’s mechanism-based classification emphasized anatomical and mechanical concepts of instability. Over time, modern systems evolved to integrate neurological evaluation and clinical relevance, resulting in improved surgical decision-making. For cervical injuries, multiple region-specific classifications exist — including Anderson–Montesano for occipital condyle fractures, Traynelis for occipito–atlantal dislocation, Fielding–Hawkins for atlantoaxial rotatory fixation, and Anderson–D’Alonzo for odontoid fractures. In the thoracolumbar region, progression from Holdsworth’s two-column theory to Denis’ three-column model, followed by Magerl’s AO classification, established the foundation for contemporary systems. The Thoracolumbar Injury Classification and Severity Score (TLICS) and its evolution — the AO Spine Thoracolumbar Classification (AO TLS) — combine morphology, neurological status, and modifiers, guiding evidence-based operative versus nonoperative management.

Spinal Stability Principles