Evidence brief
A Novel Classification System for Thoracolumbar Injuries: The TLICS
Three components: morphology, PLC integrity, neurological status
Morphology: compression (1), burst (2), translation/rotation (3), distraction (4)
PLC: intact (0), indeterminate (2), injured (3)
Neurology: intact (0), nerve root injury (2), complete (2), incomplete (3), cauda equina (3)
Score <4: non-operative, =4: surgeon discretion, >4: operative
TLICS provides a systematic, evidence-based approach to thoracolumbar injury management. It guides treatment decisions based on stability, neurology, and injury pattern.
Must calculate TLICS score in trauma viva. Components and points are heavily tested. Key concept: PLC integrity is crucial - if indeterminate, get MRI. Score ≥4 generally indicates surgery. Practice with cases: compression burst vs flexion-distraction.
Vaccaro AR et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine. 2005;30(20):2325-2333.
Level IV
Case series or case reports