Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma.
BACKGROUND
Contemporary understanding of the biomechanics, natural history, and methods of treating thoracolumbar spine injuries continues to evolve. Current classification schemes of these injuries, however, can be either too simplified or overly complex for clinical use.


METHODS
The Spine Trauma Group was given a survey to identify similarities in treatment algorithms for common thoracolumbar injuries, as well as to identify characteristics of injury that played a key role in the decision-making process.


RESULTS
Based on the survey, the Spine Trauma Group has developed a classification system and an injury severity score (thoracolumbar injury classification and severity score, or TLICS), which may facilitate communication between physicians and serve as a guideline for treating these injuries. The classification system is based on the morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient. Points are assigned for each category, and the final total points suggest a possible treatment option.


CONCLUSIONS
The usefulness of this new system will have to be proven in future studies investigating inter- and intraobserver reliability, as well as long-term outcome studies for operative and nonoperative treatment methods.
Lee
Joon Y
JY
University of Pittsburgh Medical Center, Pittsburgh, PA 19107, USA.
Vaccaro
Alexander R
AR
Lim
Moe R
MR
Oner
F C
FC
Hulbert
R John
RJ
Hedlund
Rune
R
Fehlings
Michael G
MG
Arnold
Paul
P
Harrop
James
J
Bono
Christopher M
CM
Anderson
Paul A
PA
Anderson
D Greg
DG
Harris
Mitchel B
MB
Brown
Andrew K
AK
Stock
Gordon H
GH
Baron
Eli M
EM
D000465:Algorithms; D003657:Decision Making; D006801:Humans; D015601:Injury Severity Score; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000473:pathology; D013124:Spinal Injuries / Q000145:classification* / Q000473:pathology; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000473:pathology; D015599:Trauma Severity Indices