Joaquim Andrei F, Lawrence Brandon, Daubs Michael, Brodke Darrel, Tedeschi Helder, Vaccaro Alexander R, Patel Alpesh A
J Spinal Cord Med. 2014 Jan;37(1):101-6. doi: 10.1179/2045772313Y.0000000134. Epub 2013 Nov 26.
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.
Retrospective study.
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.
Clinical and radiological data were evaluated. Patients were grouped according to the period before (2000-2006) and after (2007-2010) utilization of the TLICS.
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.
After introduction of the TLICS, there was a trend towards more successful conservative treatment with fewer conversions to surgical treatment.
胸腰段损伤分类及严重程度评分（TLICS）旨在改善胸腰段脊柱创伤（TLST）的损伤分类并指导手术决策，但尚未对其对患者治疗的影响进行量化。
回顾性研究。
对2000年至2010年在单一中心接受TLST创伤治疗的458例患者进行分析。结局指标包括神经功能状态——美国脊髓损伤协会损伤分级（AIS）、保守治疗失败及手术并发症。
评估临床和放射学数据。根据使用TLICS之前（2000 - 2006年）和之后（2007 - 2010年）的时间段对患者进行分组。
2000年至2006年，148例患者最初接受保守治疗（C组），66例接受手术治疗（S组）。C组的TLICS评分范围为1至7（中位数为1；均值为1.57）。S组的TLICS评分范围为2至10（中位数为2；均值为4.14）。97.9%接受保守治疗的患者的TLICS评分与治疗方式相符。2007年至2010年，162例患者最初接受C组治疗，82例接受S组治疗。C组的TLICS评分范围为1至4（中位数为1；均值为1.48）。S组的TLICS评分范围为2至10（中位数为4；均值为4.4）。98.8%接受C组治疗的患者的TLICS评分与治疗方式相符。总体而言，9例患者保守治疗失败；大多数失败病例（7/9）以及所有3例漏诊的牵张性损伤均发生在使用TLICS之前。
引入TLICS后，保守治疗更趋成功，转为手术治疗的情况减少。
