Volume 10, Number 6, 671-675, DOI: 10.1007/s00776-005-0956-yOpen Access

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Japanese Orthopaedic Association

Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma

Joon Y. Lee, Alexander R. Vaccaro, Moe R. Lim, F.C. Öner, R. John Hulbert, Rune Hedlund, Michael G. Fehlings, Paul Arnold, James Harrop and Christopher M. Bono, et al.

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Abstract

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.
Presented at the 78th Annual Meeting of the Japanese Orthopaedic Association, Yokohama, Japan, May 14, 2005

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