Is there a difference between narrowing of the spinal canal and neurological deficits comparing Denis and Magerl classifications?

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients: A Critical Analysis Review

» Pediatric thoracolumbar trauma, though rare, is an important cause of morbidity and mortality and necessitates early, accurate diagnosis and management.» Obtaining a detailed history and physical examination in the pediatric population can be difficult. Therefore, the threshold for advanced imaging, such as magnetic resonance imaging, is low and should be performed in patients with head injuries, altered mental status, inability to cooperate with examination, and fractures involving more than 1 column of the spine.» The classification of pediatric thoracolumbar trauma is based primarily on adult studies and there is little high-level evidence examining validity and accuracy in pediatric populations.» Injury pattern and neurologic status of the patient are the most important factors when determining whether to proceed with operative management.

Thoracolumbar burst fracture: radiographic evaluation on differences between Magerl's A and B

OBJECTIVE

Evaluate incidence of Magerl's A and B group in thoracolumbar burst fracture (Denis) according to independent examiners.

METHOD

According to the posterior spinous process split on the anterior posterior radiography, three independent examiners have analyzed the patients admitted from 2000 to 2009 with thoracolumbar burst fractures (according to Denis) to differentiate between Magerl's type A3 and B1.2. Statistical evaluation was descriptive and by using Kappa's method.

RESULTS

From the 72 patients, 11 patients compose the Magerl's type B group according to examiner 1; 10 according to examiner 2; and 17 according to examiner 3. Posterior lesion concordance was satisfactory (good, κ=0.7) between the examiners.

CONCLUSION

14 to 24% patients with thoracolumbar fractures show posterior lesion (B1.2) by using radiographic criteria. Level of evidence III, Diagnostic Studies Investigating a Diagnostic Test.