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OrthoVellum

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Not affiliated with the Royal Australasian College of Surgeons.

Spine
intermediate
X-Type

Thoracolumbar Burst Fractures - TLICS Score, Canal Compromise and Surgical Indications

Spinal Trauma

A 35-year-old construction worker falls 4 metres from scaffolding and presents with severe back pain at the thoracolumbar junction. He is neurologically intact. CT scan reveals an L1 burst fracture with 50% canal compromise and loss of vertebral body height. MRI shows an intact posterior ligamentous complex (PLC) with no signal change on fat-suppressed sequences. The TLICS (Thoracolumbar Injury Classification and Severity) score is calculated to guide treatment decisions. The spine surgeon discusses the classification, the significance of PLC integrity, and operative versus nonoperative management. Regarding thoracolumbar burst fractures and their management:

Mark each as TRUE or FALSE

A

Burst fractures involve AXIAL LOADING causing failure of BOTH the anterior and middle columns with r...

B

The TLICS (Thoracolumbar Injury Classification and Severity) score guides treatment: injury MORPHOLO...

C

Burst fractures involve only the anterior column; the lumbar spine (L4-5) is the most common locatio...

D

The POSTERIOR LIGAMENTOUS COMPLEX (PLC) comprises the supraspinous ligament, interspinous ligament, ...

E

NEUROLOGICALLY INTACT burst fractures with INTACT PLC (TLICS 2-3) can often be managed NONOPERATIVEL...

Answer the questions to see explanations

Click T (True) or F (False) for each option