Criteria
Denis classification[2]
There is no universally accepted system of classifying osteoporotic spinal compression fractures.[3][4] However, the Denis classification system, based on the three-column theory of spinal instability, is often used.
Anterior column: consists of the anterior two-thirds of the annulus and vertebral body, along with the anterior longitudinal ligament.
Middle column: consists of the posterior one third of the annulus and vertebral body, along with the posterior longitudinal ligament.
Posterior column: consists of all bony and tissue elements posterior to the anterior and middle column.
Radiographic evaluation is used to assess the number of columns involved. Fractures involving only the anterior column are stable. Those that involve the middle and/or posterior columns in addition to the anterior column may be unstable.
[Figure caption and citation for the preceding image starts]: Schematic diagram illustrating 3 columns of the Denis classificationCreated by the BMJ Publishing Group [Citation ends].
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