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Denis’ three column concept of spine stability

12 November 2009

Stable spine is one which after the initial injury does not get displaced further. The spine is stable when atleast 2 columns of the spine are intact. three column concept of spine stability

Denis’ three column concept of spine stability

According to the three column concept, the spine is considered to have 3 columns:

  • Anterior
  • Middle
  • Posterior

The anterior column is composed of:

  • Anterior longitudinal ligament
  • Anterior half of vertebral body and intervertebral disc

The middle column is composed of:

  • Posterior longitudinal ligament
  • Posterior half of vertebral body and intervertebral disc

The posterior column is composed of:

  • Transverse process
  • Spinous process
  • Pedicle
  • Lamina
  • Faceted joints
  • Interspinous ligament
  • Supraspinous ligament
  • Ligamentum flavum

Spinal injury and Three column concept:

  • One column injury is stable
  • Two column injury is unstable
  • Three column injury is invariably unstable

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