Measuring the impact of the Thoracolumbar Injury Classification and Severity Score among 458 consecutively treated patients.

Authors

• Andrei F Joaquim
• Brandon Lawrence
• Michael Daubs
• Darrel Brodke
• Helder Tedeschi
• Alexander R Vaccaro
• Alpesh A Patel

Publication/Presentation Date

1-1-2014

Abstract

CONTEXT: The Thoracolumbar Injury Classification and Severity Score (TLICS) was proposed to improve injury classification and guide surgical decision-making of thoracolumbar spinal trauma (TLST), but its impact on the care of patients has not been quantified.

STUDY DESIGN: Retrospective study.

PATIENT SAMPLE: Analysis of 458 patients treated for TLST trauma from 2000 through 2010 at a single center. Outcome measures Neurological status - ASIA Impairment Scale (AIS), failure of conservative treatment, and surgical complications.

METHODS: Clinical and radiological data were evaluated. Patients were grouped according to the period before (2000-2006) and after (2007-2010) utilization of the TLICS.

RESULTS: From 2000 to 2006, 148 patients were initially treated conservatively (C) and 66 were surgically (S) treated. In the C group, the TLICS ranged from 1 to 7 (median 1; mean 1.57). In the S group, the TLICS ranged from 2 to 10 (median 2; mean 4.14). The TLICS matched treatment in 97.9% of conservatively treated patients. From 2007 to 2010, 162 patients were initially treated C and 82 were treated S. In the C group, the TLICS ranged from 1 to 4 (median 1; mean 1.48). In the S group, the TLICS ranged from 2-10 (median 4; mean 4.4). The TLICS matched treatment in 98.8% of C-treated patients. Overall, failure of C treatment occurred in nine patients; most failures (7/9) and all three missed distractive injuries occurred prior to use of the TLICS.

CONCLUSIONS: After introduction of the TLICS, there was a trend towards more successful conservative treatment with fewer conversions to surgical treatment.

Volume

37

Issue

1

First Page

101

Last Page

106

ISSN

1079-0268

Published In/Presented At

Joaquim, A. F., Lawrence, B., Daubs, M., Brodke, D., Tedeschi, H., Vaccaro, A. R., & Patel, A. A. (2014). Measuring the impact of the Thoracolumbar Injury Classification and Severity Score among 458 consecutively treated patients. The journal of spinal cord medicine, 37(1), 101–106. https://doi.org/10.1179/2045772313Y.0000000134

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

24090484

Department(s)

Administration and Leadership

Document Type

Article