Citation

Joaquim AF, Lawrence B, Daubs M, Brodke D, Tedeschi H, Vaccaro AR, Patel AA. J. Spinal Cord Med. 2014; 37(1): 101-106.

Copyright

(Copyright © 2014, Academy of Spinal Cord Injury Professionals, Publisher Maney Publishing)

DOI

10.1179/2045772313Y.0000000134

PMID

24090484

Abstract

CONTEXT: The Thoracolumbar Injury Classification and Severity Score (TLICS) was proposed to improve injury classification and guide surgical decision-making of thoracolumbar spinal trauma (TLST), but its impact on the care of patients has not been quantified. STUDY DESIGN: Retrospective study. Patient sample: Analysis of 458 patients treated for TLST trauma from 2000 through 2010 at a single center. OUTCOME MEASURES: Neurological status - ASIA Impairment Scale (AIS), failure of conservative treatment, and surgical complications. METHODS: Clinical and radiological data were evaluated. Patients were grouped according to the period before (2000-2006) and after (2007-2010) utilization of the TLICS. RESULTS: From 2000 to 2006, 148 patients were initially treated conservatively (C) and 66 were surgically (S) treated. In the C group, the TLICS ranged from 1 to 7 (median 1; mean 1.57). In the S group, the TLICS ranged from 2 to 10 (median 2; mean 4.14). The TLICS matched treatment in 97.9% of conservatively treated patients. From 2007 to 2010, 162 patients were initially treated C and 82 were treated S. In the C group, the TLICS ranged from 1 to 4 (median 1; mean 1.48). In the S group, the TLICS ranged from 2-10 (median 4; mean 4.4). The TLICS matched treatment in 98.8% of C-treated patients. Overall, failure of C treatment occurred in nine patients; most failures (7/9) and all three missed distractive injuries occurred prior to use of the TLICS. CONCLUSIONS: After introduction of the TLICS, there was a trend towards more successful conservative treatment with fewer conversions to surgical treatment.

Language: en