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PROGNOSTIC VALUE OF THE MODIFIED TLICS COMBINED WITH CLINICAL AND MRI FINDINGS IN THORACOLUMBAR SPINE INJURY
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Abstract
Abstract
Objective: Thoracolumbar spine injuries are a common cause of disability if not promptly managed. Existing classification systems such as TLICS and AO Spine remain limited in guiding treatment decisions, particularly in patients with intermediate scores (3–4). This study aimed to evaluate the modified TLICS (mTLICS) prognostic value, incorporating clinical and Magnetic Resonance Imaging (MRI) data, and to compare it with TLICS and AO systems. Methods: A retrospective study was conducted on 104 patients with thoracolumbar spine injuries at Phu Tho General Hospital (June 2024–April 2025). Clinical data, MRI findings, and injury classifications using TLICS, AO, and mTLICS were collected. Receiver operating characteristic (ROC) analysis and multivariate logistic regression were performed to determine independent predictors of surgical indication. Results: The mTLICS system demonstrated the highest diagnostic performance in treatment stratification (AUC = 0.94 for the full sample; 0.91 for the intermediate-score group), outperforming TLICS (0.85; 0.64) and AO (0.84; 0.19). In multivariate analysis, mTLICS was the strongest independent predictor of surgical treatment (OR = 49.67; p < 0.001). MRI-based findings such as PLC injury ≥2 points and vertebral body height loss ≥50% were also significantly associated with surgical indications. Conclusion: mTLICS is an effective classification system that supports individualized treatment planning for thoracolumbar spine injuries, particularly in neurologically intact patients or those with borderline scores.
Keywords: thoracolumbar spine injury, modified TLICS, magnetic resonance imaging, surgical decision-making
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Keywords
Keywords: thoracolumbar spine injury, modified TLICS, magnetic resonance imaging, surgical decision-making.
References
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