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Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma.

Abstract：

STUDY DESIGN:Retrospective study. OBJECTIVE:Evaluate the relationship among the neurologic status, the Thoracolumbar Injury Classification System (TLICS) score, and the Magerl/AO classification system. SUMMARY OF THE BACKGROUND DATA:A wide range of classification schemes for thoracic and lumbar spine trauma have been described, but none has achieved widespread acceptance. A recent system proposed by Vaccaro et al has been developed to improve injury classification and guide surgical decision making. METHODS:Analysis of 49 patients treated surgically for thoracic and lumbar spine trauma from 2003 to 2009 in 2 spine trauma centers. Clinical and radiologic data were evaluated, classifying the trauma according to American Spinal Injury Association status, the Magerl/AO classification for fractures, and the TLICS score. RESULTS:The mean age was 37 years (range, 17-72). Thirty-five (71%) patients had a thoracolumbar fracture (T11-L2). A posterior approach was used in all the cases. American Spinal Injury Association status remained unchanged in 44 (4 had some improvement and 1 worsened). A total of 61.1% of the patients with a type A fracture were neurologically intact compared with 80% with complete neurologic deficit for type C fractures. The TLICS score range from 2 to 9 (average of 6.2). Forty-seven of 49 (96%) patients had a TLICS score greater than 4, suggesting surgical treatment. Seventy percentage of the patients with a TLICS score from 4 to 6 were neurologically intact compared with 87.5% of complete neurologic deficits in patients with TLICS 7 to 9. A statistic correlation was established between the neurologic status and AO type fracture (P = 0.0041) and the TLICS score (P < 0.0001). An association between the AO type fracture and the TLICS score was also found (P = 0.0088). CONCLUSION:The TLICS score treatment recommendation matched surgical treatment in 47 of 49 patients (96%). The TLICS was found to correlate to the AO classification. This suggests that the TLICS can be used to classify thoracolumbar trauma and can accurately predict surgical management.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Joaquim AF,Fernandes YB,Cavalcante RA,Fragoso RM,Honorato DC,Patel AA

doi

10.1097/BRS.0b013e3181c95047

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

33-6

issue

eissn

0362-2436

issn

1528-1159

journal_volume

pub_type

杂志文章,多中心研究

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Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma.