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A spinal fracture, also called a vertebral fracture or a broken back, is a fracture affecting the vertebrae of the spinal column. Most types of spinal fracture confer a significant risk of spinal cord injury. After the immediate trauma, there is a risk of spinal cord injury (or worsening of an already injured spine) if the fracture is unstable, that is, likely to change alignment without internal or external fixation.[1]

Spinal fracture
Synonyms Vertebral fracture, broken back
L1 2 vertebral fracture.jpg
Lateral spine X-ray showing osteoporotic wedge fractures of L1/2
CASH Orthosis.

Contents

TypesEdit

Risk of spinal cord injuryEdit

Vertebral fractures of the thoracic vertebrae, lumbar vertebrae or sacrum are usually associated with major trauma and can cause spinal cord injury that results in a neurological deficit.[4]

Thoracolumbar injury classification and severity scoreEdit

The thoracolumbar injury classification and severity score (TLICS) is a scoring system to determine the need to surgically treat a spinal fracture of thoracic or lumbar vertebrae. The score is the sum of three values, each being the score of the most fitting alternative in three categories:[5]

Injury type

  • Compression fracture - 1 point
  • Burst fracture - 2 points
  • Translational rotational injury - 3 points
  • Distraction injury - 4 points

Posterior ligamentous complex

  • Intact - 0 points
  • Suspected injury or indeterminate - 2 points
  • Injured - 3 points

Neurology

A TLICS score of less than 4 indicates non-operative treatment, a score of 4 indicates that the injury may be treated operatively or non-operatively, while a score of more than 4 means that the injury is usually considered for operative management.[5]

ReferencesEdit

  1. ^ "Fracture". MDguidelines by the American Medical Association. Retrieved 2017-10-26. 
  2. ^ Augustine, J.J. (21 November 2011). "Spinal trauma". In Campbell, J.R. International Trauma Life Support for Emergency Care Providers. Pearson Education. ISBN 978-0-13-300408-3. 
  3. ^ a b Clark West, Stefan Roosendaal, Joost Bot and Frank Smithuis. "Spine injury - TLICS Classification". Radiology Assistant. Retrieved 2017-10-26. 
  4. ^ Mirghasemi, Alireza; Mohamadi, Amin; Ara, Ali Majles; Gabaran, Narges Rahimi; Sadat, Mir Mostafa (November 2009). "Completely displaced S-1/S-2 growth plate fracture in an adolescent: case report and review of literature". Journal of Orthopaedic Trauma. 23 (10): 734–738. doi:10.1097/BOT.0b013e3181a23d8b. ISSN 1531-2291. PMID 19858983. 
  5. ^ a b Buck Christensen. "Thoracolumbar Injury Classification and Severity (TLICS) Scale". Medscape. Retrieved 2017-10-26.  Updated: Dec 09, 2014

External linksEdit

Classification
External resources