title: Thoracolumbar Injury Classification and Injury Severity Score System: A Literature Review of Its Safety.
abstract: Study Design Systematic literature review. Objective The Thoracolumbar Injury Classification and Severity Score System (TLICS) is widely used to help guide the treatment of thoracolumbar spine trauma. The purpose of this study is to evaluate the safety of the TLICS in clinical practice. Methods Using the Medline database without time restriction, we performed a systematic review using the keyword "Thoracolumbar Injury Classification," searching for articles utilizing the TLICS. We classified the results according to their level of evidence and main conclusions. Results Nine articles met our inclusion and exclusion criteria. One article evaluated the safety of the TLICS based on its clinical application (level II). The eight remaining articles were based on retrospective application of the score, comparing the proposed treatment suggested by the TLICS with the treatment patients actually received (level III). The TLICS was safe in surgical and nonsurgical treatment with regards to neurologic status. Some studies reported that the retrospective application of the TLICS had inconsistencies with the treatment of burst fractures without neurologic deficits. Conclusions This literature review suggested that the TLICS use was safe especially with regards to preservation or improvement of neurologic function. Further well-designed multicenter prospective studies of the TLICS application in the decision making process would improve the evidence of its safety. Special attention to the TLICS application in the treatment of stable burst fractures is necessary.
authors.affiliation: Neurosurgery Division, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Andrei Fernandes
authors.initials: AF
authors.lastname: Joaquim
authors.affiliation: Neurosurgery Division, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Dhiego Chaves
authors.initials: DC
authors.lastname: de Almeida Bastos
authors.affiliation: Neurosurgery Division, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Hélio Henrique
authors.initials: HH
authors.lastname: Jorge Torres
authors.affiliation: Department of Orthopedics, Northwestern University, Chicago, Illinois, United States.
authors.forename: Alpesh A
authors.initials: AA
authors.lastname: Patel
keywords: TLICS; evaluation; lumbar spine trauma; safety; thoracic spine trauma; thoracolumbar spine trauma
references.citation: Spine (Phila Pa 1976). 2006 May 15;31(11 Suppl):S62-9; discussion S104
references.pmid: 16685239
references.citation: J Spinal Disord Tech. 2006 Oct;19(7):477-82
references.pmid: 17021410
references.citation: J Orthop Sci. 2013 Jan;18(1):81-6
references.pmid: 23053588
references.citation: Spine (Phila Pa 1976). 2007 Apr 1;32(7):791-5
references.pmid: 17414915
references.citation: J Neurosurg Spine. 2014 May;20(5):562-7
references.pmid: 24605999
references.citation: J Bone Joint Surg Am. 2003 Jan;85-A(1):1-3
references.pmid: 12533564
references.citation: Spine (Phila Pa 1976). 2013 Apr 20;38(9):745-51
references.pmid: 23089929
references.citation: J Craniovertebr Junction Spine. 2013 Jan;4(1):3-9
references.pmid: 24381449
references.citation: Eur Spine J. 2011 Aug;20 Suppl 3:390-6
references.pmid: 21779855
references.citation: Spine (Phila Pa 1976). 2013 Aug 1;38(17):1482-90
references.pmid: 23615381
references.citation: J Bone Joint Surg Am. 2003 May;85-A(5):773-81
references.pmid: 12728024
references.citation: Spine (Phila Pa 1976). 2011 Jan 1;36(1):33-6
references.pmid: 20479700
references.citation: J Spinal Disord Tech. 2005 Feb;18 Suppl:S15-23
references.pmid: 15699801
references.citation: Asian Spine J. 2010 Dec;4(2):109-17
references.pmid: 21165314
references.citation: Skeletal Radiol. 2013 Jun;42(6):779-86
references.pmid: 23269516
references.citation: Indian J Orthop. 2007 Oct;41(4):322-6
references.pmid: 21139786
references.citation: Spine J. 2013 Dec;13(12):1760-5
references.pmid: 23602328
references.citation: J Spinal Cord Med. 2014 Jan;37(1):101-6
references.pmid: 24090484
references.citation: Spine (Phila Pa 1976). 2005 Oct 15;30(20):2325-33
references.pmid: 16227897
references.citation: Spine (Phila Pa 1976). 2007 Feb 1;32(3):E105-10
references.pmid: 17268253
references.citation: Eur Spine J. 2010 Aug;19(8):1238-49
references.pmid: 20464432
references.citation: Eur Spine J. 2013 Mar;22(3):461-74
references.pmid: 23208081