THORACOLUMBAR SPINE CODE
Among the 1434 registered patients with the International Code of Disease Control (ICD-9) of thoracic injuries, lumbar injuries, and spinal cord injuries in the medical information system, 586 patients were selected except for those patients who had injuries above the 10th thoracic vertebrae or below 3th lumbar vertebrae. We studied patients with thoracolumbar spine injury who visited our hospital from 2000 to 2016. Also, all methods were carried out in accordance with relevant guidelines and regulations.
![thoracolumbar spine thoracolumbar spine](https://slidetodoc.com/presentation_image_h2/6365bcf419647e1b6fac14870a9d2e07/image-15.jpg)
The patients were informed that we wanted to submit data for publication, and informed consent was obtained from all patients. This report and protocols were approved by the Institutional Review Board of Chonnam National University Hospital. In this study, we retrospectively reviewed the patients with thoracolumbar spine injuries who underwent magnetic resonance imaging (MRI) and discussed the validity of the TLICS classification by investigating the correlation between treatment protocol according to the TLICS classification and the treatment methods that were used actually. However, in order to enhance the reliability of the application to clinical practice, it is necessary to evaluate the validity of the TLICS classification through a large patient study. Many studies have shown that the TLICS classification has a relatively high reliability and validity, and it can be useful to select the adequate treatment plan as well as to classify the mechanism of injury 4, 5, 6. 3 presented a new classification called Thoracolumbar Injury Classification and Severity Score (TLICS) based on three factors: the morphology of injury, the integrity of the posterior ligamentous complex, and the neurologic status. Thus, a new classification is necessary 1, 2. However, their reliability and validity remain controversial because most previous classifications focused only on structural characteristics, but did not reflect neurological deficits and did not provide general guidelines for determining treatment methods. There have been several classifications of thoracolumbar injuries such as the Denis, McAfee, and AO-Magerl classifications. Despite the many studies on thoracolumbar injuries, there has been controversy in its classification and treatment. Therefore, the precise diagnosis and proper treatment of thoracolumbar injuries are important. In particular, the thoracolumbar junction is a mechanically contradictory section between the movable lumbar and relatively non-movable thoracic regions, and thoracolumbar spine injury accounts for the majority of total spinal injuries and the prevalence of injury is higher than that of other parts 1. Thoracolumbar injury is usually caused by high energy injuries and the possibility of neurological deficits due to spinal cord injury is always present. Treatment with TLICS classification showed high validity, especially in conservative group, and MRI should be an essential diagnostic tool for accurate evaluation of posterior ligamentous complex injury. We retrospectively reviewed the validity of the TLICS classification for the injuries of the thoracolumbar spine, based on MRI in a large group of patients. All of 30 mismatched patients with a TLICS score of 3 points or less (15.8%) had stable burst fracture without neurological deficit. Of the 190 patients who underwent operative treatment, 160 patients (84.2%) had a TLICS score of 4 points or more (match rate 84.2%, 160/190). Of the 138 patients who underwent conservative treatment, 131 patients (94.9%) had a TLICS score of 4 points or less, and matched with the recommendation score for conservative treatment according to the TLICS classification (match rate 94.9%, 131/138). Of the total 328 patients, 138 patients were treated conservatively and 190 patients were treated by surgery.
![thoracolumbar spine thoracolumbar spine](https://www.netterimages.com/images/vpv/000/000/005/5604-0550x0475.jpg)
The TLICS score of each group was analyzed and the degree of consistent with the recommended treatment through the TLICS classification was examined. All patients were classified into conservative and operative treatment groups. We enrolled 328 patients with thoracolumbar spine injury who underwent MRI. In order to enhance the reliability of the application to clinical practice of the TLICS classification, we retrospectively reviewed the patients with thoracolumbar spine injuries who underwent magnetic resonance imaging (MRI) and analyzed the validity of the TLICS classification and the necessity of MRI.