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Retrospective evaluation of the TLICS and TLAOSIS scales for the treatment of thoracolumbar fractures: unicentric preliminary experience
EANS Academy. Ortega-Angulo C. Sep 27, 2019; 276038; EP02110
Abstract
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Objectives: TLICS (Thoracolumbar Injury Classification System) and TLAOSIS (AOSpine Thoracolumbar Spine Injury Classification System) were developed to stablish therapeutic recommendations. We present a retrospective series, reviewing the grade of correspondence between both scales and the treatment applied in our center.
Methods: We collected clinical and radiological data from 164 patients treated for thoracolumbar fractures from 2008 to 2018. ASIA (American Spine Injury Association), TLICS and TLAOSIS scales were applied retrospectively and were compared with the decision treatment in our department.
Results: 86 patients treated conservatively and 78 operated. All patients from the conservative group were classified as ASIA E, with 96.5% having a type A fracture. TLICS in this group had a mean of 1.87 and the TLAOSIS had a mean of 2.01, being the mode=1 in both. In this group, the treatment used in our department had a correspondence of 91.02% (78 patients), with the recommendations of TLICS and 91.86% (79 patients), with TLAOSIS. In the surgical group, 70 patients (89.74%), were classified as ASIA E and 8 patients (10.25%), presented some type of neurological deficit (ASIA A-D). In this group, 63 patients (80.7%) presented type A fractures (A1:16; A2:10; A3:32; A4;5) 12 type B, and 3 type C. The mean in this group was 2.94 for TLICS and 3.51 for TLAOSIS, being the mode=2 for TLICS and 3 for TLAOSIS. The correspondence of our treatment with the actual recommendations was 35.89% for TLICS and 57.69% for TLAOSIS.
Conclusions: In the conservative group, the TLICS and TLAOSIS had a coincidence above 90%, and in the surgical group below 60%. Both scales have a high grade of correspondence for conservative approach, but great disparity for the surgical treatment, especially for those cases in the gray zone (where both treatments are valid) in relation with type A3 and A4 fractures.
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