McAfee classification of thoracolumbar spinal fractures
Citation, DOI, disclosures and article data
At the time the article was created Roberto Schubert had no recorded disclosures.
View Roberto Schubert's current disclosuresAt the time the article was last revised Frank Gaillard had no financial relationships to ineligible companies to disclose.
View Frank Gaillard's current disclosures- Thoraco-lumbar spinal fractures: McAfee classification
McAfee classification of acute traumatic spinal injuries is one of a number of thoracolumbar spinal fracture classification systems and is based on the three-column concept of the spine (of Denis). It requires CT for an accurate assessment.
Usage
Unlike the more common formal and widely used classification systems (thoracolumbar injury classification and severity score (TLICS) and AO classification of thoracolumbar injuries) that have explicit and precise classification and points schemes, the McAfee classification focuses on descriptive terms that are in common usage among clinicians, even if they are not aware of the classification system itself 2.
Classification
wedge compression: isolated anterior column compression (see wedge fracture)
stable burst: anterior and middle column compression but the posterior column is normal (see burst fracture)
unstable burst: anterior and middle column compression with disrupted posterior column
-
flexion-distraction
anterior column compression
middle and posterior column: tensile failure
axis of flexion: posterior to anterior longitudinal ligament
-
Chance fractures
pure bony injuries that extend all the way through the spinal column: from posterior to anterior through the spinous process, pedicles, and vertebral body, respectively (see chance fracture)
axis of flexion: anterior to anterior longitudinal ligament
-
translational fractures
shear force to all three columns (see thoracic spine fracture-dislocations)
References
- 1. Mcafee PC, Yuan HA, Fredrickson BE et-al. The value of computed tomography in thoracolumbar fractures. An analysis of one hundred consecutive cases and a new classification. J Bone Joint Surg Am. 1983;65 (4): 461-73. J Bone Joint Surg Am (link) - Pubmed citation
- 2. Bajamal A, Permana K, Faris M, Zileli M, Peev N. Classification and Radiological Diagnosis of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations. Neurospine. 2021;18(4):656-66. doi:10.14245/ns.2142650.325 - Pubmed
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