DENNIS THREE COLLOUM

ZA/PY

DEPARTMENT OF ORTHOPAEDI AND TRAUMATOLOGY

UNIVERSITY OF HASANUDDIN
MAKASSAR
General Vertebral Anatomy

• Consists of 33 vertebrae:
7 cervical
12 thoracal
5 lumbal
5 sacral (fused)
4 coccyx (fused)
Continue

 1983  Francis Denis

 Analyzed 412 case Thoracolumbal Injury
 Based in Radiological Finding
 Separated into 3 Column
 Anterior
 Middle
 Posterior
Denis’ Three Column Theory
Denis: Three-column model
Anterior column- formed by the ALL, the
anterior annulus, and the anterior portion
of the vertebral body

Middle osteoligamentous- the critical feature.

Very important to spinal stability; consists
of PLL, the posterior portion of the
annulus, and the posterior aspect of the
vertebral body

Posterior column- includes the neural arch,

facet joints and capsules, ligamentum
flavum, and remaining ligamentious
complex

Denis F. Clin Orthop Relat Res. 1984

Denis: Middle-column concept

 Developed to define
burst fracture

 middle column is the

primary determinant of
mechanical stability of
the thoracolumbar
region of the spine.
Denis- Minor injuries

 The minor injuries represented by fractures of

transverse processes, articular processes, pars
interarticularis, and spinous processes in- volve
only a part of the posterior column and do not
lead to acute instability.

 Isolated fractures of
 Transverse process.
 Articular process.
 pars interarticularis, or
 Spinous process.
Denis- Major injuries

Compression type
Denis- Major injuries

Burst Type

E
Denis- Major injuries

Seat belt type

 Denis- Major injuries
Fracture dislocation type

Flexion rotation Flexion Shear type

distraction