• K J Schnake, F von Scotti, N P Haas, and F Kandziora.
• Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland. klaus.schnake@bgu-frankfurt.de
• Unfallchirurg. 2008 Dec 1; 111 (12): 977-84.

BackgroundType B injuries of the thoracolumbar spine (AO classification) indicate the need for surgical treatment. Type B1 injuries include disruption of the posterior ligament complex (PLC), which can be underdiagnosed when using x-ray and CT. The aims of this study were to determine the frequency of misclassification to compile similarities of type B1 injuries.Materials And MethodsRetrospective study evaluating 361 fractures.ResultsInitially, 39 (41.9%) of 93 type B injuries were misdiagnosed as type A. 59% of 93 injuries belonged in the type B1 category. 29% of these showed no radiological signs of a PLC injury. Among the remaining cases, the following signs were the most frequently seen: vertebral segmental angle >15 degrees (44%), pronounced compression of vertebral cancellous bone despite minimal (<50%) reduced anterior vertebral height (41%), and a considerably reduced anterior vertebral height to <50% (31%).ConclusionType B injuries are frequently misinterpreted. To achieve a correct diagnosis, all clinical and radiological signs must be considered. 29% of all type B1 injuries cannot be detected on x-ray or CT scan.

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