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Thoracolumbar Spine Trauma: I. Evaluation and Classification

Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York; New York University School of Medicine, New York.

A timely and thorough evaluation of thoracolumbar injuries and rational treatment based on a complete understanding of the mechanism of bone, soft-tissue, and nerve injury is essential for maximizing the patient's neurologic and functional recovery and minimizing associated complications, the time to recovery, and the problems of long-term pain and deformity. The initial evaluation includes both clinical and radiologic assessment. Clinical evaluation includes the general trauma examination as well as a detailed spinal and neurologic examination to determine the level (or levels) of spinal injury. Radiologic evaluation includes both plain radiography and the appropriate use of advanced imaging modalities. A review of the evolution of thoracolumbar injury classifications is presented.