In 2016 the AOSpine published an algorithm for determining the need for surgical intervention on injuries to the thoracolumbar spine injuries (37).
| Type of Injury | Subtype Injury | # Points Assigned |
| Type A – Compression Fx | ||
| A0 – Minimal Injury
(e.g. transverse process fx) |
0 | |
| A1 – Compression Fx | 1 | |
| A2 – Pincer Compression Fx | 2 | |
| A3 – Incomplete Burst Fx
(only involves one end-plate) |
3 | |
| A4 – Complete Burst Fx | 5 | |
| Type B – Tension Band Injury | ||
| B1 – Osseous Disruption Tension Band | 5 | |
| B2 – Posterior Tension Band Injury
(including ligamentous injury) |
6 | |
| B3 – Anterior Tension Band Injury | 7 | |
| Type C – Translational Injury | 8 | |
| Neurological Injury | ||
| N1 – None, neurologically intact | 0 | |
| N2 – Resolved, transient symptoms | 1 | |
| N3 – Persisting radicular symptoms | 2 | |
| N4 – Incomplete spinal cord injury | 4 | |
| N5 – Complete spinal cord injury | 4 | |
| N6 – Neurological exam unattainable | 3 | |
| Patient Specific Modifiers | ||
| M1 | 1 | |
| M2 | 0 |
- Nonsurgical management: Recommended when the sum of all categories is 0–3.
- Surgical management: Recommended when the sum of all categories is ≥5.
- Consideration of either intervention: Necessary when the total equals 4.
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