ReviewInternational orthopaedics2023
Classification of thoracic spine fractures: the four-column theory.
Review in International orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The fourth column in thoracic vertebral fractures: concomitant thoracic cage injuries and mortality in 27,814 inpatient cases from the german national DRG database.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- The Integrated Nerve, Discoligamentous Complex, and Vertebra Scoring System for Thoracolumbar Junction (TLJ) Injury.Orthopaedic surgery · 2026Article
- Osteoporotic vertebral compression fracture in patients with childhood-onset lupus nephritis: prevalence and risk factors.Archives of osteoporosis · 2025Article
- Traumatic fractures of the sternum - typical distribution and need for subgroups within AO and OTA classification system?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
Corrections and comments
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Authors and funding
1 author.
Funding
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Abstract
purposeThe purpose of this study is to present a classification of thoracic spine fractures based on anatomical and biomechanical characteristics.
methodsThis is a narrative review of the literature.
resultsThe classification is based on the relationship between movement and common forces acting on the spine. A mechanistic concept is incorporated into the classification, which considers both movements and the application of forces, leading to pathomorphological characteristics. A hierarchical ranking determines the severity of fractures within the thoracic spine, and treatment recommendations are presented in each category. The fourth column of the spine is incorporated into the classification through direct and indirect mechanisms.
conclusionsThe proposed classification accommodates several advantages, such as simplicity and practicality, that make this classification helpful in daily practice. The dynamic relationship between movement and force provides a better understanding of the fracture mechanism. Finally, incorporating the fourth column will strengthen the indication for surgical management. To the best of our knowledge, this classification is the first classification developed uniquely for the thoracic spine fractures and will help to address a critical gap in the literature.
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Registered trials
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