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Denis Three-Column Classification

1.0.0

Assesses thoracolumbar fracture stability by which of Denis’s three spinal columns are injured. Select involved columns; the result states the stability implication (middle-column and two-contiguous-column injuries are unstable).

Also searched as: spine · thoracolumbar · trauma · stability · fracture

Injured columns

Select all columns with bony or ligamentous injury.

Information
Incomplete input
  • Please provide: at least one injured column.

How this tool works

Francis Denis (1983) divided the spine into anterior, middle, and posterior columns. The anterior column comprises the ALL and anterior two-thirds of the vertebral body and disc; the middle column the posterior one-third of body/disc plus PLL; the posterior column everything dorsal to the PLL (pedicles, facets, ligamentum flavum, spinous ligaments). Instability is expected when two contiguous columns are disrupted; isolated posterior-column injury is generally insufficient for frank instability. The three-column concept underpins modern AO Spine and TLICS thinking even though Denis’s original fracture typology has been superseded.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

Clinical questions that use this

Vetting guides that reach for this tool.

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