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Updated: Mar 31, 2026
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Initial disc structural preservation in type A1 and A3 thoracolumbar fractures
P Loriaut1, G Mercy2, P E Moreau1
1Service de chirurgie orthopédique et de traumatologie, université Pierre-et-Marie-Curie, hôpital Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
Purpose:
Despite a sizable amount of literature, the optimal management of thoracolumbar fractures remains controversial and many authors assume the existence of disc lesions in Magerl type A fractures. The purpose of the study was to assess the intervertebral discs in these fractures at the time of trauma. The hypothesis was that there was no change in shape and signal intensity of the discs initially.
Methods:
Fifty-one patients diagnosed with 87 types A1 and A3 thoracolumbar fractures were enrolled in a prospective study. MRI analysis involved evaluation of disc signal, height and morphological modifications according to Oner's classification.
Results:
No signal intensity modification was identified on MRI. Disc morphology was either normal or altered with creeping of discal tissue in the vertebral endplate depression. Overall, 98% of the discs were either type 1 or type 3. Mean disc height on MRI was 1.03 ± 0.36 initially.
Conclusions:
In this study, MRI showed that no loss of height occurred in discs adjacent to fractured vertebra and that there was no major alteration of the disc in terms of signal intensity and morphology. Therefore, the intervertebral disc should not be removed in Magerl type A fractures.
Level Of Evidence:
Level IV, therapeutic case series.
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