There have been several proposed classification systems to define thoracolumbar fractures. In 1983, Francis Denis described a novel classification system to facilitate the communication of these fractures and their treatments among different medical professionals. In his study, he retrospectively analyzed 412 thoracolumbar injuries and developed a three-column theory, replacing the previous two-column theory popularized by Sir Frank Holdsworth. This newly-defined three-column theory would become the foundation for a classification system that would become widely adopted by spine surgeons to formulate treatment algorithms of thoracolumbar injuries.
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