Fracturas vertebrales: revisión a las clasificaciones, clínica y manejo actuales

Abstract

The spine provides structural support and flexibility, and houses and protects the spinal cord and related nerve structures, so its normal function presupposes its stability. The main cause of vertebral fractures is trauma, which compromise the mechanical and neurological stability of the spine. Determining whether a vertebral fracture is stable or unstable is essential to decide whether the management will be conservative or surgical. This decision has been variable over time, mainly due to the lack of a universally accepted classification system for injuries. Currently, the most widely used and understandable classification is that of the AO Spine Group, which classifies fractures according to morphology, neurological status, and clinical modifiers. In this way, the understanding of the lesion is much completer and more specific for each patient, and allows better therapeutic decisions to be made. This review will describe the types of vertebral fracture according to the updated AO Spine classification for each segment of the spine (Superior Cervical and Subaxial, Thoraco-Lumbar and Sacral), describing the injuries in general forms, the associated symptoms, and the suggested management which, finally, will always be at the surgeon’s discretion according to the characteristics of each patient.