Lee et al reported the Thoracolumbar Injury Classification and Severity Score (TLICS) for evaluating a patient with trauma to the thoracolumbar spine. The authors are from multiple institutions in North America and Europe.
Patient selection: trauma to the thoracolumbar spine
Parameters:
(1) morphology
(2) neurologic involvement
(3) posterior ligamentous complex
Parameter
Finding
Points
morphology
no fracture
0
compression fracture
1
burst fracture
2
translational/rotational
3
distraction
4
neurologic involvement
intact
0
nerve root
2
cord or conus medullaris, incomplete
3
cord or conus medullaris, complete
2
cauda equina
3
posterior ligamentous complex
intact
0
injury suspected, indeterminate
2
injured
3
where:
• Translational/rotational injuries result from violent torsional and/or shear forces.
• Distraction = tensile disruption of the spinal column. It is usually associated with circumferential instability.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
TLICS Score
Management
0 to 3
nonoperative
4
nonoperative or operative
5 to 10
operative
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