J Korean Soc Spine Surg.  2017 Mar;24(1):16-23. 10.4184/jkss.2017.24.1.16.

Validity of the Thoracolumbar Injury Classification System for Thoracolumbar Spine Injuries

• Kim SK
• Lee TM
• Seo HY
• Lee WG

• KMID: 2402838
• DOI: http://doi.org/10.4184/jkss.2017.24.1.16

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To evaluate the validity of the thoracolumbar injury classification system (TLICS) when making treatment decisions in a group of thoracolumbar fracture patients. SUMMARY OF LITERATURE REVIEW: Few studies have evaluated the validity of the TLICS in consecutively treated patients, although many have evaluated the application of the TLICS to thoracolumbar injuries.
MATERIALS AND METHODS
A retrospective study was performed among the 230 patients who were treated from 2003 to 2015 in our hospital for thoracolumbar injuries. Evaluations were made of clinical outcomes and radiologic results, and each case was analysed and scored according to the American Spinal Injury Association scale, the Magerl/AO classification, and the TLICS classification by 2 spinal surgeons.
RESULTS
Of the 230 patients, 116 (50.4%) received conservative treatment and 114 (49.6%) received surgical treatment. Of the 116 patients who received conservative treatment, 112 (96.6%) were treated according to the TLICS guidelines. Conservative treatment failed for 2 of the 4 patients (1.7%) whose treatment did not correspond with TLICS, and they required surgical treatment. Of the 114 patients who underwent surgical treatment, in 87 (76.3%) the treatment corresponded to the TLICS guidelines.
CONCLUSIONS
The TLICS classification showed high validity for the conservative treatment of thoracolumbar injuries.

Keyword

Thoracolumbar spine; Fracture; TLICS Score; Surgical treatment; Conservative treatment

MeSH Terms

Classification*
Humans
Retrospective Studies
Spinal Injuries
Spine*
Surgeons

Figure

• 

  Fig. 1. A 64-year-old male patient who underwent conservative treatment for a T12 flexion-distraction injury was changed to operative treatment after collapse was observed on radiography. (A) Misdiagnosis of the flexion-distraction injury as a burst fracture in the early stage. (B) Computed tomography shows an increase in the interspinous interval and fracture of the spinous process. (C) Magnetic resonance imaging shows damage in the posterior ligamentous complex. (D) Kyphosis increased along with the collapse of the body after 3 months. (E) Implementation of posterior instrumentation. (F) Radiograph 1 year after the operation.

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  Fig. 2. A 50-year-old female patient with an L2 flexion-distraction injury who received conservative treatment. (A) Initial radiograph. (B) Computed tomography shows an increase in the interspinous interval and fracture of the spinous process. (C) After 2 years, the collapse showed minor progress, but was stabilized, and the kyphosis was also stabilized, showing no increase.

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