Denis' Three-Column Theory

Proposed by Francis Denis, three-column concept divides a spinal segment into three parts: anterior, middle, and posterior colums. 

The anterior column comprises the anterior longitudunal ligament and the anterior half of the vertebral body; the middle column comprises the posterior half of the vertebral body and the posterior longitudunal ligament; the posterior column comprises the pedicles, the facet joints and the supraspinous ligaments.

  • Denis' 3-column concept
Denis' Three-Column Theory

(AAL: Anterior longitudinal ligament, AAF: Anterior annulus fibrosus, PLL: Posterior longitudinal ligamanet, PAF: Posterior annulus fibrosus, SSL: Supraspinous ligament, ISL: Interspinous ligament, LF: Ligamentum flavum, PC: Facet capsule)

Denis used that model as the basis of his classification system of spinal fractures. Each columns have different contributions to stability, and their damages may affect stability differently. Generally, if two or more of these columns are damaged, then the spine is unstable. However, it depends on the characteristics of the fracture. More details can be found in Denis classification of spinal fractures.

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