[Clinical and radiologic legal assessment of spinal injuries using the segmental principle]

Cat scanning of the traumatized spine led to an approved classification of different types of lesions. Its application is important--not only for therapeutic reasons but also for the judgement of the end results. The classification enables the definition of a remaining instability (radiological and clinical) and is useful for the evaluation of the prognosis according to the structural changes within the motion segments. The conventional way of appreciating working capacity is no longer satisfying considering the improved diagnostic tools and the increasing frequency of various deformities, instability and even ankylosis and their combinations. As in the evaluation of peripheral joint function a concept is proposed, which is based on the structural changes in the motion segments and their motility. According to the kind and amount of deformity and instability the segment value is multiplicated with factors 1 to 6. The number of involved segments is added to obtain the definite range of working capacity. The concept is practicable in all parts of the vertebral column and allows a differentiated judgement within the usual percentages.