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The classification system described here exists in order to provide surgeons from different institutions with a common language to discuss various injuries. It provides consistency in injury diagnosis and treatment.

The AOSpine sacral fracture classification system aims to achieve international acceptance.

The classification system describes injuries based on three criteria:

1. morphology of the injury
2. neurologic status
3. case-specific modifiers

Each criterion is described below. Injuries are described by the morphologic type of the primary injury. The secondary injuries and modifiers are placed in parentheses (facet injury, neurologic status, and case specific modifiers).

Insufficiency fractures in patients with metabolic bone disease can occur:

1. with incidental or no trauma.
2. at the caudal end of spinal instrumentation constructs.