ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021
Superiority of thoracolumbar injury classification and severity score (TLICS) over AOSpine thoracolumbar spine injury classification for the surgical management decision of traumatic spine injury in the pediatric population.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed.
- Spine Trauma Classifications: Historical, Current, and Emerging Perspectives for Radiologists.The Indian journal of radiology & imaging · 2025Review
- [Effectiveness of sagittal top compression reduction technique in treatment of thoracolumbar vertebral fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023Article
- Validation of the TLICS and AOSpine injury score for surgical management of paediatric traumatic spinal injuries.Archives of orthopaedic and trauma surgery · 2023Article
- Pediatric Spine Trauma.Journal of Korean Neurosurgical Society · 2022Article
- Pharmacologic and Acute Management of Spinal Cord Injury in Adults and Children.Current treatment options in neurology · 2022Review
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Abstract
purposeThoracolumbar fractures are the most common kind of spine injury in children. Several types of spine injury can occur, and for this reason, treatment algorithms have been put in place for the management of these patients. At present, the thoracolumbar injury classification and severity score system (TLICS) and the thoracolumbar AOSpine injury score (AOSpine score) aimed at providing treatment recommendations. We aimed to assess the reliability, in children, of the TLICS scoring and AOSpine scoring systems, and to define the superiority of one of the methods of scoring, to spread its use in routine clinical management in the pediatric spine trauma.
methodsA retrospective chart review of consecutive children admitted to a Level 1 trauma center for traumatic thoracolumbar fractures, between 2006 and 2019, was performed. We compared the management we performed in clinical practice in children with spine trauma, to the decisional algorithms based on the TLICS and AOSpine scores. According to these scores, surgical treatment should be performed when the TLICS score ≥ 5 and the AOSpine score > 5; and surgical or conservative treatment was considered reasonable when the TLICS score = 4 and the AOSpine score = 4 or 5. Surgical indications were based on the clinical status, the anatomy of the fracture, and the risk of sagittal imbalance of the growing spine.
resultsFifty-four patients met the inclusion criteria. We demonstrated that both the AOSpine score and the TLICS scores had a significant correlation for surgical management decision of spine trauma (p < 0.0001). We found a high concordance between surgical decision making in the pediatric clinical practice and the TLICS score. In our pediatric cohort, there were significantly more patients with TLICS ≥ 5 (n = 47, 87%) than with AOSpine score > 5 (n = 26, 46%, p < 0.0001). There were significantly more patients with TLICS ≥ 4 (n = 53, 98%), than with AOSpine score ≥ 4 (n = 42, 77%, p = 0.001). ConclusionsThe TLICS score was significantly more appropriate than the AOSpine score, for the surgical treatment decision in children, especially when considering the future risk of sagittal imbalance.
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