Difference between revisions of "Unstable spine fractures"

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Revision as of 15:47, 22 March 2016



Denis' three column concept helps to determine whether a vertebral fracture is stable or unstable

  • I: Anterior column
    • Anterior longitudinal ligament
    • Anterior 1/2 of the vertebral body and disk
  • II: Middle column
    • Posterior 1/2 of the vertebral body and disk
    • Posterior longitudinal ligament
  • III: Posterior column
    • Facet joints
    • Ligament flavum
    • Posterior elements

Clinical Features

  • I:Always stable
  • II:Possibly unstable
  • III:Always unstable

Example of Unstable Fractures


  • CT with reconstructions
  • Consider plain x-ray in conjunction as this is what is used during orthospine f/u
  • MRI to assess cord and ligament damage


  • C-collar
  • Consult ortho or spine as needed

See Also