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Denis classification of spinal fractures

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Denis divided the spine into three columns - anterior, middle and posterior. If two or more of these columns are damaged then the spine is unstable.

  • the anterior column comprises the anterior longitudunal ligament and the anterior half of the vertebral body.

  • the middle column comprises the posterior half of the vertebral body and the posterior longitudunal ligament.

  • the posterior column comprises the pedicles, the facet joints and the supraspinous ligaments.

In adition to proposing the 'three column spine' Denis also defined four types of spinal fractures;

  • wedge fracture - stable
  • burst fracture - stable
  • seat belt fracture (and 'Chance fracture') - unstable
  • fracture dislocation - unstable

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