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TLICS — Thoracolumbar Injury Classification & Severity Score

TLICS (Vaccaro 2005)

Scores thoracolumbar fractures from injury morphology (1–4), posterior ligamentous complex integrity (0–3) and neurologic status (0–3). Totals guide management: ≤ 3 nonoperative, 4 indeterminate, ≥ 5 surgical.

Also searched as: spine · trauma · fracture · spine fracture · burst

Injury morphology
Posterior ligamentous complex
Neurologic status
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  • Please provide: injury morphology, posterior ligamentous complex integrity, neurologic status.

How this tool works

The Thoracolumbar Injury Classification and Severity Score (Vaccaro 2005, Spine Trauma Study Group) combines three independent determinants of stability. Morphology: compression 1 (burst adds 1 = 2), translation/rotation 3, distraction 4. Posterior ligamentous complex: intact 0, suspected/indeterminate 2, injured 3. Neurologic status: intact 0, nerve root 2, complete cord/conus injury 2, incomplete cord/conus injury 3, cauda equina 3. There is no additional points modifier for ongoing neural compression in the original TLICS (that modifier belongs to the related SLICS system for subaxial cervical injuries). The sum maps to management: 0–3 nonoperative, 4 indeterminate (either approach), ≥ 5 operative. Clinical qualifiers such as ankylosing disorders, osteoporosis or polytrauma can shift treatment independent of the score.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

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