Case No. _______ Fracture Level _______ Examiner: __________
Columns of Ligamentous or Bony Injury
Number of Columns Involved _______
Please Draw The Injury Pattern On the Above Diagrams, Note Which Columns Are Affected, and Count the Number of Columns Injured
Displacement in Any Plane
Please Evaluate the Injury in Terms of Translatory Displacement, and Mark the Appropriate Category - Either Less Than 25%, or Greater Than 25%
Angulation
Please Evaluate the Injury in Terms of Angulation, and Mark the Appropriate Category - Either No Significant Angulation, or Significant Angulation
Complementary Information
The Canal Compromise and Loss of Height scores no not directly affect the selection of Type A, Type B, or Type C. These items are complementary to the Fracture Classification and collected as a means to correlate compromise in the neurologic function. The loss of Height variable helps guide the management team in selection of surgical approach and fixation device, if surgery is indicated.
Canal Compromise
Please Evaluate the Injury in Terms of Canal Compromise, Estimate the Approximate Percentage, and Score on the Above Scale
Please record the patient's ASIA Impairment Score (A-E) on line ______
Loss of Height
Please Evaluate the Injury in Terms of Loss of Height, Estimate the Approximate Percentage, and Score on the Above Scale
Copyright 1997 - Midwest Regional Spinal Cord Injury Care System, Chicago IL
