• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.174-177
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• 2015

Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

• 한국식품영양학회지
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• 제11권2호
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• pp.165-170
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• 1998

교통사고로 인한 척추골절 환자 S75에서 손상부위에 따른 진단방사선학 및 보존적 치료 소견을 임상 문헌과 함께 고찰해 본 결과 다음과 같은 결론을 얻었다. 1. 흉요추 좌측방 단순필름에서 L1 요추에 설상변형 정도가 약 10%인 쐐기형 압박골절이 확인되었다. 2. L1 요추의 CT촬영 결과 추체부 전면에 궁형의 불규칙한 골 절편을 관찰할 수 있었으며, T12∼L1는 구조상 손상빈도가 높은 부위로 밝혀졌으며, Denis의 골절형태는 중간주와 후방주가 잘 보존된 전방주의 다발성 압박골절로 분류되었고, Cobb의 척추 만각증은 없었으며, Frankel의 신경손상 분류형태는 E형이었다. 3. 정형외과적 치료방법은 비수술 요법의 보존적 치료를 원칙으로 하였고, 수분·전해질, 영양 및 혈장제 대용으로 공급하는 수액과 함께 브스테로이드성 항염진통제, 근육 이완제를 투여하면서 철저한 침상안정을 유도하였다. 4. 수상후 3주째는 폴리에틸렌 back corset를 착용하고 조기재활을 시도하였으며, 수상 8주 후에도 경도의 불편감이 남아 있었으나, 추시 관찰한 결과 일정기간이 지나면서 점차 척추는 안정성을 찾게 되었다.