6.5 Thoracolumbar spine trauma classification systems

2009 ◽  
Keyword(s):  
Thoracolumbar Spine ◽  
Classification Systems ◽  
Spine Trauma

Thoracolumbar spine trauma classification: the Thoracolumbar Injury Classification and Severity Score system and case examples

2009 ◽  
Vol 10 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Alpesh A. Patel ◽  
Andrew Dailey ◽  
Darrel S. Brodke ◽  
Michael Daubs ◽  
James Harrop ◽  
...  
Keyword(s):  
Severity Score ◽  
Injury Severity ◽  
Thoracolumbar Spine ◽  
Neurological Status ◽  
Classification Systems ◽  
Spine Trauma ◽  
Injury Characteristics ◽  
Severity Of Injury ◽  
Thoracolumbar Injury ◽  
Injury Classification

Object The aim of this study was to review the Thoracolumbar Injury Classification and Severity Score (TLICS) and to demonstrate its application through a series of spine trauma cases. Methods The Spine Trauma Study Group collaborated to create and report the TLICS system. The TLICS system is reviewed and applied to 3 cases of thoracolumbar spine trauma. Results The TLICS system identifies 3 major injury characteristics to describe thoracolumbar spine injuries: injury morphology, posterior ligamentous complex integrity, and neurological status. In addition, minor injury characteristics such as injury level, confounding variables (such as ankylosing spondylitis), multiple injuries, and chest wall injuries are also identified. Each major characteristic is assigned a numerical score, weighted by severity of injury, which is then summated to yield the injury severity score. The TLICS system has demonstrated initial success and its use is increasing. Limitations of the TLICS system exist and, in some instances, have yet to be addressed. Despite these limitations, the severity score may provide a basis to judge spinal stability and the need for surgical intervention. Conclusions By addressing both the posterior ligamentous integrity and the patient's neurological status, the TLICS system attempts to overcome the limitations of prior thoracolumbar classification systems. The TLICS system has demonstrated both validity and reliability and has also been shown to be readily learned and incorporated into clinical practice.

scholarly journals Review of best classification systems for diagnosing and treating thoracolumbar spine trauma

2021 ◽  
Vol 12 ◽  
pp. 242
Author(s):  
Alecio Cristino Evangelista Santos Barcelos ◽  
Franz Jooji Onishi ◽  
Andrei Fernandes Joaquim ◽  
Ricardo Vieira Botelho
Keyword(s):  
Treatment Guidelines ◽  
Thoracolumbar Spine ◽  
Case Series ◽  
Neurological Status ◽  
Classification Systems ◽  
Instability Criterion ◽  
Spinal Instability ◽  
Spine Trauma ◽  
Neurological Damage ◽  
Instability Criteria

Background: Improved thoracolumbar spine trauma classification (TLSTC) systems can better help diagnose and treat thoracolumbar spine trauma (TLT). Here, we identified the types of injury (rationale and description), instability criteria, and treatment guidelines of TLSTC. Methods: We used the PubMed/MEDLINE database to assess TLSTC according to the following variables: injury morphology, injury mechanism, spinal instability criteria, neurological status, and treatment guidelines. Results: Twenty-one studies, 18 case series and three reviews were included in the study. Treatment guidelines were proposed in 16 studies. The following three major parameters were identified in TLSTC studies: injury morphology (19/21 studies), posterior ligamentous complex (PLC) disruption alone as the main spinal instability criterion (15 studies), and neurological damage (12 studies). Most classification systems neglected the severity of vertebral body comminution. Conclusion: We identified here the 3 main parameters for the evaluation of diagnosis and treatment of TLT: injury morphology, PLC disruption, and neurological damage. Based on our review, we may conclude that further clinical validation studies of TLSTC are warranted.

Thoracolumbar Spine Trauma: Pearls and Pitfalls of the Newer Classification Systems

Neurographics ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 86-96
Author(s):  
E. Bonfante ◽  
A. Tenreiro ◽  
J. Choi ◽  
E. Supsupin ◽  
R. Riascos
Keyword(s):  
Thoracolumbar Spine ◽  
Classification Systems ◽  
Spine Trauma

Thoracolumbar Spine Trauma

2019 ◽  
pp. 491-501
Author(s):  
Kelley E. Banagan ◽  
Daniel L. Cavanaugh ◽  
Ian Bussey ◽  
Alysa Nash ◽  
Jael E. Camacho-Matos ◽  
...  
Keyword(s):  
Thoracolumbar Spine ◽  
Spine Trauma

Thoracolumbar Burst Fractures

2018 ◽  
pp. 123-132
Author(s):  
Omaditya Khanna ◽  
Geoffrey P. Stricsek ◽  
James S. Harrop
Keyword(s):  
Treatment Options ◽  
Thoracolumbar Spine ◽  
Axial Loading ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Thoracolumbar Injury ◽  
Fall From Height ◽  
Thoracolumbar Spine Fractures

Ten to twenty percent of all thoracolumbar spine fractures are burst fractures. Burst fractures are typically a result of an axial-loading mechanism, such as from jumping or a fall from height. In this chapter, the authors provide an overview of the different classification systems for thoracolumbar fractures, including the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification system and Thoracolumbar Injury Classification and Severity (TLICS) score. The various treatment options, both surgical and nonsurgical, are discussed, including criteria for when surgical intervention is warranted. The authors discuss the various surgical approaches for treatment of these fractures and their relative efficacies and outcomes. Finally, the authors review the evidence, outcomes, and potential complications of the various treatment options in order to aid the surgeon in their decision-making when these fractures are encountered in their practice.

36. Timing of surgery for thoracolumbar spine trauma: patients with neurological injury

2019 ◽  
Vol 19 (9) ◽  
pp. S18
Author(s):  
Jack H. Ruddell ◽  
John M. DePasse ◽  
Oliver Y. Tang ◽  
Alan H. Daniels
Keyword(s):  
Thoracolumbar Spine ◽  
Timing Of Surgery ◽  
Neurological Injury ◽  
Trauma Patients ◽  
Spine Trauma

scholarly journals AOSpine—Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles

2019 ◽  
Vol 9 (1_suppl) ◽  
pp. 77S-88S ◽  
Author(s):  
Srikanth N. Divi ◽  
Gregory D. Schroeder ◽  
F. Cumhur Oner ◽  
Frank Kandziora ◽  
Klaus J. Schnake ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Injury Severity ◽  
Thoracolumbar Spine ◽  
Spinal Column ◽  
Narrative Review ◽  
Patient Specific ◽  
Upper Cervical Spine ◽  
Spine Trauma ◽  
Subaxial Cervical Spine

Study Design: Narrative review. Objectives: To describe the current AOSpine Trauma Classification system for spinal trauma and highlight the value of patient-specific modifiers for facilitating communication and nuances in treatment. Methods: The classification for spine trauma previously developed by The AOSpine Knowledge Forum is reviewed and the importance of case modifiers in this system is discussed. Results: A successful classification system facilitates communication and agreement between physicians while also determining injury severity and provides guidance on prognosis and treatment. As each injury may be unique among different patients, the importance of considering patient-specific characteristics is highlighted in this review. In the current AOSpine Trauma Classification, the spinal column is divided into 4 regions: the upper cervical spine (C0-C2), subaxial cervical spine (C3-C7), thoracolumbar spine (T1-L5), and the sacral spine (S1-S5, including coccyx). Each region is classified according to a hierarchical system with increasing levels of injury or instability and represents the morphology of the injury, neurologic status, and clinical modifiers. Specifically, these clinical modifiers are denoted starting with M followed by a number. They describe unique conditions that may change treatment approach such as the presence of significant soft tissue damage, uncertainty about posterior tension band injury, or the presence of a critical disc herniation in a cervical bilateral facet dislocation. These characteristics are described in detail for each spinal region. Conclusions: Patient-specific modifiers in the AOSpine Trauma Classification highlight unique clinical characteristics for each injury and facilitate communication and treatment between surgeons.

scholarly journals Subaxial cervical spine trauma classification: the Subaxial Injury Classification system and case examples

2008 ◽  
Vol 25 (5) ◽  
pp. E8 ◽  
Author(s):  
Alpesh A. Patel ◽  
Andrew Dailey ◽  
Darrel S. Brodke ◽  
Michael Daubs ◽  
Paul A. Anderson ◽  
...  
Keyword(s):  
Classification System ◽  
Severity Score ◽  
Injury Severity ◽  
Neurological Status ◽  
Classification Systems ◽  
Spine Trauma ◽  
Prognostic Information ◽  
Cervical Trauma ◽  
Injury Characteristics ◽  
Injury Classification

Object The authors review a novel subaxial cervical trauma classification system and demonstrate its application through a series of cervical trauma cases. Methods The Spine Trauma Study Group collaborated to create the Subaxial Injury Classification (SLIC) and Severity score. The SLIC system is reviewed and is applied to 3 cases of subaxial cervical trauma. Results The SLIC system identifies 3 major injury characteristics to describe subaxial cervical injuries: injury morphology, discoligamentous complex integrity, and neurological status. Minor injury characteristics include injury level and osseous fractures. Each major characteristic is assigned a numerical score based upon injury severity. The sum of these scores constitutes the injury severity score. Conclusions By addressing both discoligamentous integrity and neurological status, the SLIC system may overcome major limitations of earlier classification systems. The system incorporates a number of critical clinical variables—including neurological status, absent in earlier systems—and is simple to apply and may provide both diagnostic and prognostic information.

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