Turkish Neurosurgery
Is Thoracolumbar Injury Classification and Severity Score (TLICS) Superior to AO Thoracolumbar Injury Classification System for Guiding the Surgical Management of Unstable Thoracolumbar Burst Fractures without Neurologic Deficit?
Mehmet Onur Yüksel1, Mehmet Sabri Gürbüz2, Merih İş3, Hakan Somay3
1Erzurum Bölge Training and Research Hospital, Neurosurgery, Erzurum,
2Safa Hospital, Neurosurgery, İstanbul,
3Haydarpaşa Training and Research Hospital, Neurosurgery, İstanbul,
DOI: 10.5137/1019-5149.JTN.19094-16.2

Aim:The aim of this study was to determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and AOSpine Thoracolumbar Injury Classification System have any superiority to each other regarding the reliability of their recommendations in the surgical management of unstable thoracolumbar burst fractures.Material and Methods:Fifty-five consecutive patients with thoracolumbar burst fractures undergoing instrumentation between 2010 and 2015 were analyzed retrospectively. TLICS and AO systems were compared based on patients’ ASIA scores and they were analyzed for their safety and reliability.Results:A total of 55 patients were studied. Neurologic deficits were detected in 18 patients and the remaining 37 patients had normal neurologic functions. All the patients with neurologic deficits received >4 points according to TLICS. There were 14 patients with incomplete spinal cord injury and all of them received >4 points according to TLICS (p<0.01). On the other hand; 8 of these 14 patients received 4 points according to AO system. None of the 37 patients without neurologic deficit received <4 points of TLICS whereas; 18 of these 37 patients received 3 AO points, to whom AO recommends conservative treatment despite the fact that they had instable burst fractures (p<0.01). Conclusion:Our results have revealed that the recommendations of TLICS might be more reliable than those of AO particularly for guiding the surgical management of unstable thoracolumbar burst fractures without neurologic deficit. However; this conclusion needs to be verified with further multicenter prospective studies.

Corresponding author : Mehmet Onur Yüksel