AOSpine Thoracolumbar Spine Injury Classification System in determining the treating tactics of thoracolumbar junction traumatic injuries (literature review)

Authors

  • O.S. Nekhlopochyn State Institution “Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • M.V. Vorodi State Institution “Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine; O.O. Bogomolets National Medical University, Kyiv, Ukraine
  • Ie.V. Cheshuk State Institution “Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine; O.O. Bogomolets National Medical University, Kyiv, Ukraine

DOI:

https://doi.org/10.22141/1608-1706.2.23.2022.893

Keywords:

thoracolumbar junction, traumatic injuries, classification, AOSpine

Abstract

The anatomical features of the thoracolumbar junction determine the significant predisposition of this area to traumatic injuries. The treatment tactics thoracolumbar junction lesion is quite controversial. A large number of methods have been proposed to demonstrate their effectiveness in various types of da-mage. However, a single concept that defines a specific method of treatment for a certain set of pathomorphological changes has not yet been formed. The trend of the last ten years is the development and active introduction into clinical practice of tactically oriented clinical classifications of traumatic injuries of sertain part of the spine. These classifications consider a number of heterogeneous factors and providе а clinician with a more or less clear scheme of therapeutic measures. As to the thoracolumbar junction, such a classification is AOSpine Thoracolumbar Spine Injury Classification System. The scheme was developed in order to characterize injuries of the entire thoracic and lumbar spine, while the features of the thoracolumbar junction, as in the previously proposed classifications, are practically not taken into account. The classification is based on the assessment of 3 basic criteria: the morphological cha-
racteristics of the fracture, the neurological status of the patient, and clarifying clinical modifiers. The hierarchy of the distribution of types of traumatic injuries corresponds to an increase in the severity degree. There are 3 main types: compression injuries; failure of the
posterior or anterior ligamentous complex; damage accompanied by displacement in any plane. When developed the prurpose was the creation of a fairly simple, universal and well-reproducible classification in order to reflect global surgical preferences and determine the most rational approach to treatment. This review provides a detailed description of all damage options. It has been established that despite the high reproducibility of the results, the classification actually remains a descriptive tool, without assuming the definition of any tactics for each specific classified case. The thoracolumbar spine injury severity scale, which is based on the AO classification, is considered as a tool for quantitative assessment of the severity of injury. The scale, based on the sum of points characterizing a certain damage, allows you to make a choice in favor of either surgical or conservative treatment. The scheme proposed by the Spine Section of the German Society for Orthopaedics and Trauma is considered as the most detailed algorithm for the treatment of injuries to the thoracolumbar spine. The algorithm is based on the AOSpine Thoracolumbar Spine Injury Classification System, but uses a number of additional morphological modifiers, which made it possible to more adequately determine the most rational treatment method for a particular type of injury.

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Published

2022-07-08

How to Cite

Nekhlopochyn, O., Vorodi, M., & Cheshuk, I. (2022). AOSpine Thoracolumbar Spine Injury Classification System in determining the treating tactics of thoracolumbar junction traumatic injuries (literature review). TRAUMA, 23(2), 68–78. https://doi.org/10.22141/1608-1706.2.23.2022.893

Issue

Section

Review