Adult Trauma Patients With Thoracolumbar Injury Classification and Severity Score of 4: A Systematic Review

Authors

Alexandria F. Naftchi, School of Medicine, New York Medical College.
Sima Vazquez, School of Medicine, New York Medical College.
Eris Spirollari, School of Medicine, New York Medical College.
Austin B. Carpenter, Department of Neurosurgery, Westchester Medical Center, Valhalla.
Christina Ng, School of Medicine, New York Medical College.
Sabrina Zeller, Department of Neurosurgery, Westchester Medical Center, Valhalla.
Eric Feldstein, Department of Neurosurgery, Westchester Medical Center, Valhalla.
Cameron Rawanduzy, School of Medicine, New York Medical College.
Ankita Das, School of Medicine, New York Medical College.
Christian Gabriele, School of Medicine, New York Medical College.
Ronan Gandhi, Department of Neurosurgery, Westchester Medical Center, Valhalla.Follow
Alan Stein, Department of Neurosurgery, Westchester Medical Center, Valhalla.
Ilya Frid, Department of Neurosurgery, Westchester Medical Center, Valhalla.
Jose F. Dominguez, Department of Neurosurgery, Westchester Medical Center, Valhalla.
Simon J. Hanft, Department of Neurosurgery, Westchester Medical Center, Valhalla.Follow
John K. Houten, Department of Neurosurgery, Maimonides Medical Center, New York, NY.
Merritt D. Kinon, Department of Neurosurgery, Westchester Medical Center, Valhalla.Follow

Author Type(s)

Student, Resident/Fellow, Faculty

DOI

10.1097/BSD.0000000000001380

Journal Title

Clinical Spine Surgery

First Page

237

Last Page

242

Document Type

Article

Publication Date

7-1-2023

Department

Neurosurgery

Abstract

STUDY DESIGN: Systematic review. OBJECTIVE: Evaluate characteristics of patients with thoracolumbar injury classification and severity (TLICS) score of 4 (To4) severity traumatic thoracolumbar injury. SUMMARY OF BACKGROUND DATA: The TLICS score is used to predict the need for operative versus nonoperative management in adult patients with traumatic thoracolumbar injury. Ambiguity exists in its application and score categorization. METHODS: A systematic review of the literature was performed. The databases of MEDLINE, Embase, Web of Science, and Cochrane Review were queried. Studies included adults with traumatic thoracolumbar injury with assigned TLICS score and description of management strategy. RESULTS: A total of 16 studies met inclusion criteria representing 1911 adult patients with traumatic thoracolumbar injury. There were 503 (26.32%) patients with To4, of which 298 (59.24%) were operative. Studies focusing on the thoracolumbar junction and AO Type A fracture morphology had To4 patient incidences of 11.15% and 52.94%, respectively. Multiple studies describe better quality of life, pain scores, and radiographic outcomes in To4 who underwent operative treatment patients. CONCLUSION: To4 injuries are more commonly AO Type A and located in the thoracolumbar junction in adult patients with traumatic thoracolumbar injury. Despite ambiguous recommendations regarding treatment provided by TLICS, outcomes favor operative intervention in this subset of traumatic thoracolumbar injury patients.

Recommended Citation

Naftchi, A. F., Vazquez, S., Spirollari, E., Carpenter, A. B., Ng, C., Zeller, S., Feldstein, E., Rawanduzy, C., Das, A., Gabriele, C., Gandhi, R., Stein, A., Frid, I., Dominguez, J. F., Hanft, S. J., Houten, J. K., & Kinon, M. D. (2023). Adult Trauma Patients With Thoracolumbar Injury Classification and Severity Score of 4: A Systematic Review. Clinical Spine Surgery, 36 (6), 237-242. https://doi.org/10.1097/BSD.0000000000001380