Department of Neurology, State University of Campinas, Campinas-SP, Brazil.
Spine (Phila Pa 1976). 2011 Jan 1;36(1):33-6. doi: 10.1097/BRS.0b013e3181c95047.
Retrospective study.
Evaluate the relationship among the neurologic status, the Thoracolumbar Injury Classification System (TLICS) score, and the Magerl/AO classification system.
A wide range of classification schemes for thoracic and lumbar spine trauma have been described, but none has achieved widespread acceptance. A recent system proposed by Vaccaro et al has been developed to improve injury classification and guide surgical decision making.
Analysis of 49 patients treated surgically for thoracic and lumbar spine trauma from 2003 to 2009 in 2 spine trauma centers. Clinical and radiologic data were evaluated, classifying the trauma according to American Spinal Injury Association status, the Magerl/AO classification for fractures, and the TLICS score.
The mean age was 37 years (range, 17-72). Thirty-five (71%) patients had a thoracolumbar fracture (T11-L2). A posterior approach was used in all the cases. American Spinal Injury Association status remained unchanged in 44 (4 had some improvement and 1 worsened). A total of 61.1% of the patients with a type A fracture were neurologically intact compared with 80% with complete neurologic deficit for type C fractures. The TLICS score range from 2 to 9 (average of 6.2). Forty-seven of 49 (96%) patients had a TLICS score greater than 4, suggesting surgical treatment. Seventy percentage of the patients with a TLICS score from 4 to 6 were neurologically intact compared with 87.5% of complete neurologic deficits in patients with TLICS 7 to 9. A statistic correlation was established between the neurologic status and AO type fracture (P = 0.0041) and the TLICS score (P < 0.0001). An association between the AO type fracture and the TLICS score was also found (P = 0.0088).
The TLICS score treatment recommendation matched surgical treatment in 47 of 49 patients (96%). The TLICS was found to correlate to the AO classification. This suggests that the TLICS can be used to classify thoracolumbar trauma and can accurately predict surgical management.
回顾性研究。
评估神经状态、胸腰椎损伤分类系统（TLICS）评分和 Magerl/AO 分类系统之间的关系。
已经描述了多种用于胸腰椎创伤的分类方案，但没有一种方案得到广泛认可。最近，Vaccaro 等人提出了一种新的系统，旨在改善损伤分类并指导手术决策。
分析了 2003 年至 2009 年在 2 个脊柱创伤中心接受手术治疗的 49 例胸腰椎创伤患者的临床和影像学资料。根据美国脊柱损伤协会（ASIA）状态、Magerl/AO 骨折分类和 TLICS 评分对创伤进行分类。
平均年龄为 37 岁（范围 17-72 岁）。35 例（71%）患者存在胸腰椎骨折（T11-L2）。所有病例均采用后路入路。44 例（4 例有所改善，1 例恶化）的 ASIA 状态保持不变。A型骨折患者中有 61.1%的神经功能完整，而 C 型骨折患者中有 80%的完全神经功能缺损。TLICS 评分为 2-9 分（平均 6.2 分）。49 例患者中有 47 例（96%）TLICS 评分大于 4，提示手术治疗。TLICS 评分在 4-6 分的患者中有 70%的神经功能完整，而 TLICS 评分在 7-9 分的患者中有 87.5%的完全神经功能缺损。神经状态与 AO 型骨折（P = 0.0041）和 TLICS 评分（P < 0.0001）之间存在统计学相关性。AO 型骨折与 TLICS 评分之间也存在相关性（P = 0.0088）。
TLICS 评分治疗建议与 49 例患者中的 47 例（96%）手术治疗相匹配。TLICS 评分与 AO 分类相关。这表明 TLICS 可用于胸腰椎创伤分类，并能准确预测手术治疗。
