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TLICS = Thoracolumbar Injury Classification and Severity Score, developed by Vaccaro et al. (2005).

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It uses three key parameters to score thoracolumbar spine trauma:

  1. Injury morphology (how the vertebra is fractured).
  2. Posterior ligamentous complex (PLC) integrity.
  3. Neurologic status.

Scoring System

Score Morphology PLC (Posterior Ligamentous Complex) Integrity Neurological Status
0 Intact Intact
1 Compression Nerve root injury
2 Burst fracture Suspected / indeterminate Complete spinal cord injury
3 Translation / rotation injury Definite injury (disruption on MRI / widening of interspinous distance, facet malalignment) Incomplete spinal cord injury
or
Cauda equina injury
4 Distraction injury

Interpretation

Total score Interpretation
≤ 3 Conservative management (brace, observation).
= 4 Gray zone → clinical judgment (either conservative or surgical depending on patient/PLC suspicion).
≥ 5 Surgical stabilization indicated.

Advantages

Limitations