Neurosurgery Division, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Department of Orthopedics, Northwestern University, Chicago, Illinois, United States.
Global Spine J. 2016 Feb;6(1):80-5. doi: 10.1055/s-0035-1554775. Epub 2015 Jun 5.
Study Design Systematic literature review. Objective The Thoracolumbar Injury Classification and Severity Score System (TLICS) is widely used to help guide the treatment of thoracolumbar spine trauma. The purpose of this study is to evaluate the safety of the TLICS in clinical practice. Methods Using the Medline database without time restriction, we performed a systematic review using the keyword "Thoracolumbar Injury Classification," searching for articles utilizing the TLICS. We classified the results according to their level of evidence and main conclusions. Results Nine articles met our inclusion and exclusion criteria. One article evaluated the safety of the TLICS based on its clinical application (level II). The eight remaining articles were based on retrospective application of the score, comparing the proposed treatment suggested by the TLICS with the treatment patients actually received (level III). The TLICS was safe in surgical and nonsurgical treatment with regards to neurologic status. Some studies reported that the retrospective application of the TLICS had inconsistencies with the treatment of burst fractures without neurologic deficits. Conclusions This literature review suggested that the TLICS use was safe especially with regards to preservation or improvement of neurologic function. Further well-designed multicenter prospective studies of the TLICS application in the decision making process would improve the evidence of its safety. Special attention to the TLICS application in the treatment of stable burst fractures is necessary.
系统文献回顾。目的：胸腰椎损伤分类与严重度评分系统（TLICS）广泛用于指导胸腰椎创伤的治疗。本研究旨在评估 TLICS 在临床实践中的安全性。方法：使用无时间限制的 Medline 数据库，我们使用关键字“Thoracolumbar Injury Classification”进行了系统综述，搜索了使用 TLICS 的文章。我们根据证据水平和主要结论对结果进行了分类。结果：符合纳入和排除标准的文章有 9 篇。其中 1 篇文章基于 TLICS 的临床应用评估了其安全性（II 级）。其余 8 篇文章基于该评分的回顾性应用，比较了 TLICS 建议的治疗方案与患者实际接受的治疗方案（III 级）。在神经功能方面，TLICS 在手术和非手术治疗中是安全的。一些研究报告称，TLICS 的回顾性应用与无神经损伤爆裂性骨折的治疗不一致。结论：本文献回顾表明，TLICS 的使用是安全的，特别是在保留或改善神经功能方面。进一步设计良好的多中心前瞻性研究将提高 TLICS 应用于决策过程的安全性证据。需要特别注意 TLICS 在稳定爆裂性骨折治疗中的应用。
