ROLE OF THORACOLUMBAR INJURY CLASSIFICATION AND SEVERITY SCORE (TLICS) SYSTEM IN DIAGNOSTIC AND PROGNOSTIC EVALUATION OF THORACOLUMBAR SPINAL TRAUMA USING CT AND MRI
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 19
Abstract
BACKGROUND Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. A comprehensive classification system is required for classifying thoracolumbar injuries that not only includes all the essential elements guiding therapeutic management, but accurately anticipates prognosis. The TLICS (Thoracolumbar Injury and Classification Severity Score) system promises to include all the essential elements required while evaluation of Thoracolumbar trauma. The aim of this study was to assess the clinical utility of this scoring system in classifying thoracolumbar spinal injuries. MATERIALS AND METHODS This is a prospective observational study. Patients referred from Department of Orthopaedics with history of Thoracolumbar (T10- L2) trauma who underwent Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of Thoracolumbar Spine were included in this study. The included patients were classified according to TLICS system based on the CT and MRI findings. They were then followed-up to correlate with surgeons’ choice of treatment, i.e. surgery or conservative management. The patients were further followed to look for neurological improvement after treatment. RESULTS Total number of patients assessed (n): 110. The TLICS score was 100% sensitive in predicting surgery, whereas the specificity was 32%. Positive predictive value was 69.8% and the negative predictive value was 100%. Diagnostic accuracy was 73.6%. The ROC (Receiver Operator Curve) analysis showed that the score correctly classified 93.1% cases with the best cut-off TLICS score for dividing surgical and non-surgical groups being > 4. CONCLUSION CT and MR imaging together complete the imaging assessment of thoracolumbar injury. The TLICS score is a comprehensive injury grading scale that combines injury morphology, assessment of mechanical stability pertaining to the Posterior Ligamentous Complex and neurologic status. It should be incorporated into routine clinical practice to analyse, evaluate and report spine injuries.
Authors and Affiliations
Amit Disawal, Prajwalitsing Pratapsing Gour, Vandana Jahanvi
Keywords
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- EP ID EP418191
- DOI 10.14260/jemds/2018/524
- Views 61
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