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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    Thoracolumbar Injury Classification and Severity Scale (TLICS)

    Classifies thoracolumbar spine injury and provides treatment recommendations.

    INSTRUCTIONS

    Requires appropriate imaging (at least CT) to determine posterior instability for accurate interpretation.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with thoracolumbar fracture involving vertebral body, pars, or pedicle, and any significant ligamentous injury.

    • Make sure to have appropriate imaging to evaluate the posterior column. On CT, look for widened facet joints and interspinous spaces. If posterior columns are not visualized on CT, then MRI is required.

    • If a patient has a neurological deficit, it is strongly advised to carefully review films to help determine if decompression would be beneficial to the patient.
    • Consider patient’s comorbidities and other underlying pathologies that may have predisposed the patient to injury, e.g. osteopenia/osteoporosis, infection, malignancy.

    Intuitive, evidence-based method for determining spinal instability.

    Compression fracture
    +1
    Burst fracture
    +2
    Translational/rotational
    +3
    Distraction
    +4
    None of the above
    0
    Intact
    0
    Nerve root
    +2
    Complete cord
    +2
    Incomplete cord
    +3
    Cauda equina
    +3
    Intact
    0
    Injury suspected or indeterminate
    +2
    Injured
    +3

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Joon Y. Lee

    About the Creator

    Joon Y. Lee, MD, is an orthopedic surgeon at the University of Pittsburgh Medical Center. He is also a professor in the orthopedic surgery department at the University of Pittsburgh. Dr. Lee’s primary research is focused on cervical, thoracic, and lumbar spine surgery.

    To view Dr. Joon Y. Lee's publications, visit PubMed

    Are you Dr. Joon Y. Lee? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Christopher Storey, MD, PhD
    About the Creator
    Dr. Joon Y. Lee
    Are you Dr. Joon Y. Lee?
    Content Contributors
    • Christopher Storey, MD, PhD