TLICS — Thoracolumbar Injury Classification and Severity
Guides surgical vs conservative management of thoracolumbar fractures. Score ≥ 5 suggests surgery; ≤ 3 conservative; 4 = clinical judgement.
Score interpretation
TLICS ≤ 3: Conservative management appropriate.
→ Thoracolumbar orthosis (TLSO) for 8–12 weeks. Analgesia. Mobilise with brace. Serial X-rays at 6 weeks, 3 months, 6 months to assess healing. Physiotherapy for rehabilitation. Neurology review if any neurological deficit.
TLICS = 4: Equivocal — surgical vs conservative. MDT decision.
→ Spinal MDT discussion. Consider patient factors: age, bone quality, medical fitness, occupation, pain severity. MRI if PLC integrity uncertain. Neurosurgery / spine surgeon review.
TLICS ≥ 5: Surgery recommended for stabilisation and/or decompression.
→ Spine surgeon review. Surgical options: posterior pedicle screw fixation ± decompression (laminectomy) for incomplete cord injury. Timing: urgent (< 24h) for deteriorating neurological deficit. ASIA scoring. Spinal cord injury unit referral. Steroids: methylprednisolone controversial — follow local protocol.
Interpretation bands for the TLICS. Apply clinical judgement and local guidance.
References
- 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.
Related
Curated clinical cross-links plus same-class fallbacks.
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Indocyanine Green (Intravitreal Chromovitrectomy) · Diagnostic Dye — Vitreoretinal Surgery / ICG Angiography
- Trypan Blue 0.06% (Ophthalmic) · Ophthalmic Dye — Capsule Staining (Cataract Surgery)
- Acetylcholine 1% Intraocular Solution · Cholinergic — Intraocular Miotic (Cataract Surgery)
- Bupivacaine (Orthopaedic Nerve Blocks) · Local Anaesthetic — Long-acting Amide
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.