Abstract
Objective: To assess the correlation between the Denis classification and clinical outcomes.
Subjects and Design: We performed a retrospective study of 87 patients with spinal injuries in the thoracolumbar region. All patients were admitted to the Oswestry Spinal injuries unit between Jan 1990 and December 1998. Following a review of their notes, CT scans and radiographs, we attempted to classify their injuries according to the Denis (3 column) Classification of spinal injuries.
Outcome Measures: The patients were assessed both at the time of presentation and on subsequent follow up. Neurological function was assessed using the Frankel classification.
Results: The results of the study show that the correlation between Denis classification and clinical outcome is poor. In addition, the relative proportions of the two most common Major Injury types described by Denis were reversed in our study with Burst fractures forming the majority of injuries. This difference in out come was attributed primarily to the increased use of CT scanning in our study. It appears that Denis misdiagnosed a significant number of burst (two column) fractures as compression (anterior column) fractures.
Conclusions: Our findings showed no correlation between the degree of instability and the number of columns disrupted. We believe that only 3 column fracture dislocations are fundamentally unstable. In addition, our results support the practise of treating vertebral fractures by conservative means with no apparent correlation between treatment modality and neurological outcome at long term follow up.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
References:
1 Denis F. The three-column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine1983 Vol 8: 8; 817–831 Google Scholar
2 Boerger T. O, Limb D. , Dickson. Review Article: Does Canal Clearance Affect Neurological Outcome After Thoraco Lumbar Burst Fractures? R. A. JBJS (Br)2000; 82-B; 629–35 Google Scholar
