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Evaluation of TLICS for thoracolumbar fractures

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Abstract

Purpose

Thoracolumbar Injury Classification and Severity Score (TILCS), facilitates the communication between physicians, and guides to treatment decision with better outcome. A composite injury severity score is calculated from these characteristics stratifying patients into operative and non-operative treatment. Aim of this study is to identify the effectiveness of TLICS scoring for thoracolumbar vertebral fractures without neurological deficits and the efficacy of conservative treatment in patients with TILCS 4.

Methods

58 patients with thoracolumbar fracture were included. 38 patients with TLICS 1–3 (group A) and 20 patients with TLICS 4 (group B) treated conservatively, were evaluated with traditional two-plain radiographic examination, CT-scan and MRI. The pain and functional scales were used in the clinical evaluation. Local kyphosis angle, sagittal index and height loss percentage were measured in the radiologic evaluation. Mean follow-up period was 28 months. Post-fracture and follow-up values were compared. Functional scores and clinical outcomes of the groups were compared.

Results

The mean pain (1 = worse pain, reverse-VAS) and functional scores at the final follow-up were 8.2 and 86 points, respectively (group A), 6.4 and 76 points (group B). The mean period for returning to work was 3.2 (group A) and 3.8 months (group B). Comparing the two groups did not demonstrate any statistical difference of their clinical and functional outcomes.

Conclusion

The study’s results demonstrate that conservative treatment for TLICS 4 thoracolumbar fractures can be safely applied. The conservative treatment of cases scoring TLICS 4 is equally effective to those scoring ≤3.

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Conflict of interest

The authors state that no conflict of interest exists. All authors have made an important contribution to the study. The study has been approved by IRB of our hospital as required.

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Authors and Affiliations

  1. 3rd Orthopaedic Department, University of Athens, Nikis 2, Kifisia, 14561, Athens, Greece

    Spiros G. Pneumaticos, Panagiotis K. Karampinas, George Triantafilopoulos, Spiros Koufos, Vasilios Polyzois & John Vlamis

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  1. Spiros G. Pneumaticos
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  2. Panagiotis K. Karampinas
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  3. George Triantafilopoulos
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  4. Spiros Koufos
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  5. Vasilios Polyzois
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  6. John Vlamis
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Correspondence to Panagiotis K. Karampinas.

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Pneumaticos, S.G., Karampinas, P.K., Triantafilopoulos, G. et al. Evaluation of TLICS for thoracolumbar fractures. Eur Spine J 25, 1123–1127 (2016). https://doi.org/10.1007/s00586-015-3889-y

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  • DOI: https://doi.org/10.1007/s00586-015-3889-y

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