Role and indications of MRI in acute spine trauma and its effect on TLICS classification

Abstract

Thoracolumbar trauma is a critical entity as early diagnosis and adequate management may improve patients’ outcome and decrease its inherent disability, most common causes of thoracolumbar trauma is fall from height followed by accidents then fall on back. Although grouped together, TLST is comprised of injures to the more rigid thoracic spine (T1-T10), the flexible and transitional thoracolumbar junction (T11-L2), more susceptible to injuries, and the lumbar spine L3-5. Magnetic resonance is recommended, especially in patients with neurological deficits, in the evaluation of the disc, ligaments, and neural elements. MR has been used to obtain information about the status of the posterior ligamentous complex, a critical determinant of surgical decision-making. TLICS, a new system was proposed by the Spine Trauma Study Group to help surgeons to treat thoracic and lumbar spine fractures. Three major characteristics associated with patient outcome (neurological and spinal stability) were considered and evaluated. These three main characteristics are: 1) injury morphology, 2) integrity of the posterior ligamentous complex (PLC), and 3) neurological status.