Denis three-column classification
Trauma and orthopaedics
Also known as: Drei-Säulen-Modell nach Denis · Denis üç kolon sınıflaması · Denis three-column concept (thoracolumbar spine injuries)
What it is for
Divides the thoracolumbar spine into three longitudinal columns and describes four major injury types by which columns fail and how; injury of two contiguous columns (always including the middle column) is regarded as unstable.
Classification
| Category | Description |
|---|---|
| Anterior column | anterior longitudinal ligament, anterior annulus fibrosus, anterior part of the vertebral body. |
| Middle column | posterior wall of the vertebral body, posterior annulus fibrosus, posterior longitudinal ligament. |
| Posterior column | everything behind the posterior longitudinal ligament: pedicles, facet joints, laminae, spinous processes and the posterior ligamentous complex. |
| Compression fracture | anterior column fails in compression; middle column intact. |
| Burst fracture | anterior and middle columns fail in compression, with loss of posterior body height and possible retropulsion into the canal. |
| Seat-belt type (flexion-distraction) | posterior and middle columns fail in tension; anterior column intact. |
| Fracture-dislocation | all three columns fail (compression, tension, rotation or shear) with subluxation or dislocation. |
Source
The three column spine and its significance in the classification of acute thoracolumbar spinal injuries
Spine 1983;8:817–831 (Denis F)
DOI: 10.1097/00007632-198311000-00003
PMID: 6670016
- Edition
- Denis 1983 (largely superseded by the AO Spine thoracolumbar classification, but the column concept is still used)
- Checked on
Summary of the published classification in our own words. Not a substitute for the original publication.
A question about this classification?
Medelix answers clinical questions from guidelines and studies – every statement with its source.