Mechanisms of Injury
Signs and Symptoms: Initial Evaluation and Management
Imaging and Other Diagnostic Studies
Surgical and Applied Anatomy and Common Surgical Approaches
Surgical and Applied Anatomy
Comparative Studies of Various Surgical Approaches
Management of Complications
Authors’ Preferred Treatment
Controversies and Future Directions
Timing of Surgery
Minimally Invasive Surgical Techniques
From: Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al. A new classification of thoracolumbar injuries: The importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine. 2005;30:2325–2333.
Following the algorithm described in TLICS (Fig. 45-33), the TLICS score (Table 45-1) is calculated by considering fracture morphology, the integrity of the PLC and the patient’s neurologic status. Patients with scores of 3 or less are treated nonoperatively whereas those with scores of 5 or higher are treated with surgical stabilization and fusion. Patients with a score of 4 will be treated with a trial of nonoperative treatment if they do not have a PLC injury or neurologic deficit whereas those with either a neurologic injury or PLC injury should be stabilized expediently to optimize the likelihood of neurologic recovery and minimize the risk of secondary displacement due to ligamentous instability.