Acute burst fractures. A comparative analysis of a modern fracture classification and pathologic findings.

Ten acute thoracolumbar burst fractures (T11-L3) in eight spinal specimens were investigated regarding injuries to the bony, ligamentous, and neural structures. The fractures were subdivided into three groups, which were compared to the different burst fractures proposed by Denis in 1983. In the specimens, it was impossible to separate Denis Type A and B fractures. The Type D fractures showed pronounced instability. These latter fractures were subdivided into two groups: one with rupture of the bony vertebral arch (D) and one with rupture of the posterior ligaments (D2). The Denis A or B fractures were not associated with macroscopic or microscopic damage to the spinal cord or cauda equina, or both. However, in the six Denis D fractures, the neural tissue was transected in one case and severely compressed in four cases.