Assessment of load-sharing thoracolumbar injury: A modified scoring system

Abstract

BACKGROUND Many classification systems of thoracolumbar spinal fractures have been proposed to enhance treatment protocols, but none have achieved universal adoption. AIM To develop a new patient scoring system for cases with thoracolumbar injury classification and severity score (TLICS) = 4, namely the load-sharing thoracolumbar injury score (LSTLIS). METHODS Based on thoracolumbar injury classification and severity score, this study proposes the use of the established load-sharing classification (LSC) to develop an improved classification system (LSTLIS). To prove the reliability and reproducibility of LSTLIS, a retrospective analysis for patients with thoracolumbar vertebral fractures has been conducted. RESULTS A total of 102 cases were enrolled in the study. The scoring trend of LSTLIS is roughly similar as the LSC scoring, however, the average deviation based on the former method is relatively smaller than that of the latter. Thus, the robustness of the LSTLIS scoring method is better than that of LSC. LSTLIS can further classify patients with TLICS = 4, so as to assess more accurately this particular circumstance, and the majority of LSTLIS recommendations are consistent with actual clinical decisions. CONCLUSION LSTLIS is a scoring system that combines LSC and TLICS to compensate for the lack of appropriate inclusion of anterior and middle column compression fractures with TLICS. Following preliminary clinical verification, LSTLIS has greater feasibility and reliability value, is more practical in comprehensively assessing certain clinical circumstances, and has better accuracy with clinically significant guidelines.

Reliability and repeatability of a modified thoracolumbar spine injury classification scoring system

“…Due to the unique anatomical location and characteristics of the thoracolumbar segment, the clinical manifestations and treatment after injury differ from those of thoracic and lumbar fractures. If timely diagnosis and treatment are not obtained, or if the treatment method chosen is unreasonable, it is not conducive to improving the long-term quality of life of patients (2,3). The classification of thoracolumbar fractures is important for clinical treatment and prognosis.…”

The difference and clinical application of modified thoracolumbar fracture classification scoring system in guiding clinical treatment

“…Therefore, it is crucial to rapidly and accurately assess the fracture injury status and employ appropriate treatment measures to achieve better therapeutic outcomes [ 1 ]. A reliable and effective thoracolumbar fracture classification scoring system is essential to achieve this objective [ 2 – 4 ]. Currently, the most commonly used classification systems for thoracolumbar fractures in clinical practice include Denis classification, AO classification, and TLICS classification.…”

Comparison of the Outcomes between AO Type B2 Thoracolumbar Fracture with and without Disc Injury after Posterior Surgery

“…Currently, posterior pedicle screw fixation is one of the most commonly recognized surgical methods because of its effectiveness in stabilizing the spinal column in a shorter operation time, Even though canal compromise can only be retracted by posterior indirect decompression when the posterior longitudinal ligament is not injured 7,8 . The indication for long or short‐segment fixation is mainly based on the morphology of the vertebral body and the severity of the kyphosis 9,10 . However, the morphology of the disc is rarely discussed.…”

“… 7 , 8 The indication for long or short‐segment fixation is mainly based on the morphology of the vertebral body and the severity of the kyphosis. 9 , 10 However, the morphology of the disc is rarely discussed.…”