Thoracolumbar Injury Classification and Severity Score in Children: A Validity Study.

The Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a valid tool for assessing the need for surgical intervention in adult patients. There is limited insight into its usefulness in children. To assess the validity of the TLICS system in pediatric patients. The medical records for pediatric patients with acute, traumatic thoracolumbar fractures at two Level 1 trauma centers were reviewed retrospectively. A TLICS score was calculated for each patient using computed tomography and magnetic resonance images, along with the neurological examination recorded in the patient's medical record. TLICS scores were compared with the type of treatment received. Receiver operating characteristic (ROC) curve analysis was employed to quantify the validity of the TLICS scoring system. TLICS calculations were completed for 165 patients. The mean TLICS score was 2.9 (standard deviation ± 2.7). Surgery was the treatment of choice for 23% of patients. There was statistically significant agreement between the TLICS suggested treatment and the actual treatment received (P < 0.001). The ROC curve calculated using multivariate logistic regression analysis of the TLICS system's parameters as a tool for predicting treatment demonstrated excellent discriminative ability, with an area under the ROC curve of 0.96, which was also statistically significant (P < 0.001). The TLICS system demonstrates good validity for selecting appropriate thoracolumbar fracture treatment in pediatric patients.

Dawkins RL ，Miller JH ，Menacho ST ，Ramadan OI ，Lysek MC ，Kuhn EN ，Tubbs RS ，Walker ML ，Walters BC ，Agee BS ，Rozzelle CJ ... -  《-》

Thoracolumbar Injury Classification and Severity Score in children: a reliability study.

Dawkins RL ，Miller JH ，Ramadan OI ，Lysek MC ，Kuhn EN ，Rocque BG ，Conklin MJ ，Tubbs RS ，Walters BC ，Agee BS ，Rozzelle CJ ... -  《-》

Multicenter retrospective evaluation of the validity of the Thoracolumbar Injury Classification and Severity Score system in children.

Sellin JN ，Steele WJ 3rd ，Simpson L ，Huff WX ，Lane BC ，Chern JJ ，Fulkerson DH ，Sayama CM ，Jea A ... -  《-》

The Reliability and Validity of the Thoracolumbar Injury Classification System in Pediatric Spine Trauma.

Savage JW ，Moore TA ，Arnold PM ，Thakur N ，Hsu WK ，Patel AA ，McCarthy K ，Schroeder GD ，Vaccaro AR ，Dimar JR ，Anderson PA ... -  《-》

Modified thoracolumbar injury classification and severity score (TLICS) and its clinical usefulness.

Thoracolumbar injury classification and severity score (TLICS) is not very reliable for assessment of injury to the posterior ligament complex, even when scored by experts. It is not reasonable to score every compression fracture or burst fracture the same as there is great variety in the severity of compression fractures and burst fractures. To propose a modified TLICS (mTLICS) and evaluate the performance of the mTLICS system by measuring the agreement between scores determined by radiologists using both systems and actual treatment procedure delivered. We retrospectively evaluated 134 patients with acute lumbar and thoracic spinal trauma after undergoing magnetic resonance imaging (MRI) using new mTLICS and conventional TLICS system. Inter-observer agreements of TLICS and mTLICS scores were analyzed using the kappa statistic. Nonparametric correlation analysis was used to determine correlation (R) among each score and the surgical intervention. The mTLICS system showed slightly higher correlation than TLICS (Rs, TLICS, 0.592 and 0.613 vs. mTLICS, 0.628 and 0.639). If we consider a total maximal score of 4 to be a negative surgical indication, mTLICS showed significantly higher sensitivities than TLICS, and if we consider a total minimal score of 4 to be a positive surgical indication, mTLICS showed significantly higher specificities than TLICS. The mTLICS score corrects deficiencies in the TLICS system that lead to ambiguity in the radiological diagnostic criteria. mTLICS is a more suitable scoring system than TLICS for predicting surgical management accurately, especially for morphological injuries.

Park HJ ，Lee SY ，Park NH ，Shin HG ，Chung EC ，Rho MH ，Kim MS ，Kwon HJ ... -  《-》