Fundamentals in Spinal Surgery for Residents-Thoracolumbar Trauma

Video Transcription

Video Summary

The video discusses thoracolumbar trauma and classification systems for these injuries. The AO classification, which has been around for 20 years, categorizes injuries into compression (type A), distraction (type B), and rotational (type C) injury patterns. The severity of the injury increases from A to C and within each type, severity increases from A1 to A3. The telix score is a useful classification system for surgical decision-making and is based on injury morphology, posterior ligamentous complex status, and neurologic status. A score less than 4 indicates nonoperative management, while a score greater than 4 indicates operative management, with 4 being the gray zone. Another classification system called the load-sharing classification helps determine the need for anterior column support based on the amount of disruption and kyphosis present. The video then discusses various management strategies for different types of thoracolumbar injuries, including compression fractures, stable burst fractures, flexion-distraction injuries, fracture dislocations, and gunshot wounds. The importance of minimizing unnecessary surgical interventions is emphasized, and non-operative approaches are often preferred for stable fractures. The video also touches on the debate of whether to remove instrumentation a year later and the importance of considering cost-effectiveness when making treatment decisions. No specific credits were given for the video.

Asset Caption

David O. Okonkwo, MD, PhD, FAANS

Keywords

thoracolumbar trauma

AO classification

telix score

management strategies

compression fractures

non-operative approaches

cost-effectiveness