The Three-column Concept

The three-column concept, as described by Denis [17], is one commonly used method for determining the stability of thoraco-lumbar spine fractures. The spinal column is divided into three columns, with the middle column acting as a fulcrum between the others.

The posterior column consists of the pedicles, transverse processes, laminae, facets and spinous processes.

The middle column comprises the posterior portion of the vertebral body and the posterior longitudinal ligament.

The anterior column consists of the anterior longitudinal ligament and the anterior portion of the vertebral body.