Magerl classification of thoracolumbar spinal fractures

Last revised by Frank Gaillard on 19 Feb 2020

The Magerl classification, one of many thoracolumbar spinal fracture classification systems, was adopted as the original AO classification in 1994 but has since then been superseded: see the current AO classification of thoracolumbar injuries.


Although the Magerl classification is based on the three-column concept by Denis and the McAfee classification it has largely been superseded by more modern classification systems (particularly the current AO classification of thoracolumbar injuries and the thoracolumbar injury classification and severity score) whereas the terminology introduced by Denis and McAfee continue to be used in everyday clinical practice. 


The Magerl classification relies exclusively on CT findings.

A: compression injuries
  • A1: impaction fractures
    • A1.1: endplate impaction
    • A1.2: wedge impaction
    • A1.3: vertebral body collapse
  • A2: split fractures
    • A2.1: frontal split fracture
    • A2.2: sagittal split fracture
    • A2.3: pincer fracture
  • A3: burst fractures
    • A3.1: incomplete burst fracture
    • A3.2: burst split fracture
    • A3.3: complete burst fracture
      • A3.3.1: pincer
      • A3.3.2: flexion
      • A3.3.3: axial
B: distraction injuries
  • B1: predominantly transligamentous flexion-distraction injury
    • B1.1: with transverse disc disruption
      • B1.1.1: flexion subluxation
      • B1.1.2: anterior dislocation
      • B1.1.3: B1.1.1 or B1.1.2 the with fractures of the articular processes
    • B1.2: with type A vertebral body fracture
  • B2: predominantly osseous flexion-distraction injury
    • B2.1: transverse bi column fracture
    • B2.2: posterior osseous disruption with transverse disc disruption
      • B2.2.1: through the pedicles
      • B2.2.2: through the interarticular portions (flexion spondylolysis)
    • B2.3: with type A vertebral body fracture
      • B2.3.1: through the pedicles
      • B2.3.2: through the isthmus
  • B3: anterior disruption through the disc
    • B3.1: hyperextension-subluxation
    • B3.2: hyperextension-spondylolysis
    • B3.3: posterior dislocation
C: torsion injuries
  • C1: rotation-compression injury
    • C1.1: impaction
    • C1.2: split
    • C1.3: burst
  • C2: rotation-distraction injury
    • C2.1: with transligamentous flexion-distraction
    • C2.2: with transosseous flexion-distraction
    • C2.3: with hyperextension-distraction
  • C3: rotational shear injury

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Cases and figures

  • Magerl A1.2: wedged impaction
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  • Magerl A2.1: frontal split compression injury
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  •  Magerl A3.1: incomplete burst
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  • Magerl A3.3.3: axial complete burst
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  • Magerl B2.2.2: traumatic spondylolysis
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  • Magerl C3: shear injury
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