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Understanding the pathomechanics of the fractures in the ankylosed spine is important in the differentiation of the acute spinal fractures in DISH and ankylosing spondylitis. This article emphasizes the imaging features of spinal DISH and acute spinal fractures in DISH, distinguishing them specifically from those in ankylosing spondylitis.

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Our data suggest that TLICS is a valuable tool in a spine surgeon's armamentarium in treating thoracolumbar junction injuries. Some surgeons might be more likely to operate on thoracolumbar junction injuries that should be treated nonoperatively according to the TLICS score. As with all classification schemes, the TLICS system should be used in conjunction with sound clinical judgment.