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Thoracic and Lumbar Spine Injuries

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A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status.
Vaccaro AR, Lehman RA Jr, Hurlbert RJ, Anderson PA, Harris M, Hedlund R, Harrop J, Dvorak M, Wood K, Fehlings MG, Fisher C, Zeiller SC, Anderson DG, Bono CM, Stock GH, Brown AK, Kuklo T, Oner FC.
Spine (Phila Pa 1976). 2005 Oct 15;30(20):2325-33.

Rationale for inclusion: Established the Thoracolumbar Injury Classification and Severity Score based on morphology, integrity and neurologic status.

Citations - 635 (as of July 2017)

Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study.
Wood K, Buttermann G, Mehbod A, Garvey T, Jhanjee R, Sechriest V.
J Bone Joint Surg Am. 2003 May;85-A(5):773-81.

Rationale for inclusion: RCT comparing operative versus nonoperative treatment of thoracolumbar burst fractures.  Operative management offered no benefit when neurologic exam and spine stability were present.

Citations - 529 (as of July 2017)

Spinal instability as defined by the three-column spine concept in acute spinal trauma.
Denis F.
Clin Orthop Relat Res. 1984 Oct;(189):65-76.

Rationale for inclusion: The 3 column spine concept is described from a review of 412 thoracolumbar spine injuries.  

Citations - 994 (as of July 2017)

The three column spine and its significance in the classification of acute thoracolumbar spinal injuries.
Denis F.
Spine (Phila Pa 1976). 1983 Nov-Dec;8(8):817-31.

Rationale for inclusion: The concept of the middle column is introduced and the 3 column classification is correlated with stability and therapy.

Citations - 3277 (as of July 2017)

The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I.
Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH, Vernon JD, Walsh JJ.
Paraplegia. 1969 Nov;7(3):179-92.

Rationale for inclusion: 612 patients with closed spinal injuries were described and managed with postural reduction in bed for several weeks.  All but 4 patients achieved spinal stability in this manner.

Citations - 2745 (as of July 2017)

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