Thoracolumbar fracture classification: evolution, merits, demerits, updates, and concept of stability

Thoracolumbar fracture classification system is required to facilitate effective communication between spine surgeons, to guide treatment, and to help predict the prognosis. An ideal classification system should be simple, comprehensive, reliable, and reproducible with predictive outcomes. Unfortunately, most of the existing classifications have certain merits and demerits and they failed to fulfill the above criteria; some are oversimplified while others are too inclusive and complex for routine use. Given the scenario where none of the classifications is accepted worldwide, it is imperative to understand the evolution of thoracolumbar injury classification. The authors concisely review the subject from its inception in the year 1929 to the present day.