• Journal of Korean Neurosurgical Society
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• v.57 no.3
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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.

• The Korean Journal of Food And Nutrition
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• v.11 no.2
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• pp.165-170
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• 1998

Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.