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Thoracolumbar Injury Classification and Severity Scale (TLICS)

Guides operative versus non-operative management of thoracolumbar spine trauma.

Thoracolumbar Injury Classification and Severity Scale (TLICS)
Injury morphology
Posterior ligamentous complex (PLC) integrity
Neurologic status
Result0 points

Non-operative management

Suggested management
Non-operative management

When to use

  • Classifying thoracolumbar spine trauma to guide the decision between non-operative and operative management.

Formula

TLICS = Morphology (0-4) + posterior ligamentous complex integrity (0-3) + neurologic status (0-3). Score <=3 favours non-operative treatment, 4 is indeterminate, >=5 favours operative treatment.

Pearls and pitfalls

  • Designed to be more reproducible than purely mechanistic classifications by explicitly weighting neurologic status and ligamentous integrity.

References

  1. 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 (Phila Pa 1976). 2005;30(20):2325-33.