Do spinal distraction injuries always involve PLC?

[neuromedstu]

Hello!

I read here on https://radiologyassistant.nl/musculoske...sification that on the TLICS grading scale, a distraction injury always involves the posterior ligamentous complex (PLC) and therefore by definition is surgical (4 pts for morphology + 3 pts for PLC involvement)

However, the AO classification system has a Type B3 distraction-hyperextension category that does not seem (at least on the illustrations, attached below) to involve the PLC

Can anyone provide clarification on this?

Thank you!

[Guest]

Distraction is just one descriptor, not the whole injury pattern. Distraction type injuries almost always involve either a flexion or an extension moment in addition to distraction. The extension-distraction (B3) injury you posted could have an intact PLC. A severe flexion-distraction injury (e.g. B2) will almost certainly not.

That's why the PLC gets a separate category in TLICs, it's related to but not determined by morphology.

[neuromedstu]

(05-04-2021, 12:59 AM)Guest Wrote: Distraction is just one descriptor, not the whole injury pattern. Distraction type injuries almost always involve either a flexion or an extension moment in addition to distraction. The extension-distraction (B3) injury you posted could have an intact PLC. A severe flexion-distraction injury (e.g. B2) will almost certainly not.

That's why the PLC gets a separate category in TLICs, it's related to but not determined by morphology.

Thank you for the wonderful response