Context The Thoracolumbar Injury Classification Program (TLICS) has been described to greatly help doctors in the decision-making procedure for thoracolumbar spinal trauma. and with AO type A accidents are treated. AO type B and C accidents surgically are maintained, in regards to to neurological position. Sufferers with cauda equina or incomplete accidents received an increased intensity rating also. Controversies remain regarding the administration of unpredictable burst fractures without neurological position. The role from the posterior ligamentous complicated position as well as the magnetic resonance imaging in the decision-making procedure require more clinical evidence. stated that the ligamentous structures in AO type A fractures, compression and burst fractures, are intact. However, the literature widely defines burst fractures wherein the posterior ligamentous structures are thought to be injured (i.e. unstable burst fractures).4 For our study, we assume that type A injuries can have an intact PLC, thus receiving no points, have a suspected PLC injury at the magnetic resonance imaging (MRI) (two extra points) or a total disruption, with three extra points. Results Results are categorized according to the suggested treatment based on TLICS total score and summarized in non-surgical treatment (1C3 points C Table?2), surgical or non-surgical treatment (4 points C Table?3), and surgical treatment (5C10 points C Table?4). Table?2 Classification of the patients with a TLICS score from 1 to 3 points according to the AO classification system and neurological status Table?3 Classification of the patients with a TLICS score of 4 points according to the AO classification system and neurological status Table?4 Classification of the patients with a TLICS score from 5 to 10 points according to the AO classification system and neurological status Non-surgical treatment C TLICS 1C3 points (Table?2) All potential injuries in this group, receiving 1C3 points, are AO type A injuries. No patients with an incomplete neurological deficit or cauda equina syndrome are included in this group. Surgical or non-surgical treatment C TLICS 4 points (Table?3) All potential injuries in this category were AO type Mela A fractures. The neurological status can range from intact to complete spinal cord injury. Surgical treatment C TLICS 5C10 points (Table?4) In this group, all the three AO fracture patterns are possible. All the type B and C injuries belong to the surgical group of the TLICS system, regardless of neurological status (6.4; 7.3, 8.2; 8.3; 9 and 10). Although compression fractures can theoretically reach this severity score leading to surgical HOE 32020 supplier treatment (5.3; 5.4), we believe that these clinical scenarios are rare. Unstable burst fractures (5.1; 7.1; 7.2 and 8.1) regardless of the neurological status are proposed to be treated surgically. Stable burst fractures with incomplete HOE 32020 supplier neurological deficit may be surgically treated (5.2), as well as some burst fractures with indeterminate PLC injury and with either nerve root injury (6.2) or complete spinal cord injury (6.3). Discussion The TLICS score has a strong association with the neurological status and the three main types of the Magerl classification system. In a previous study, Joaquim et al.5 found a statistically significant association between the neurological status (normal or changed) and the AO type fracture (P?=?0.0041) or the TLICS score (P?P?=?0.0088). Non-surgical group C TLICS??3 In the non-surgical HOE 32020 supplier treatment group, all the patients have type A injuries. With an exception of patients with the TLICS of two points (burst fractures C neurologically intact C PLC intact), all the other have compression injuries. Of note, patients in the 3.2 and 3.3 groups have complete neurological deficit and nerve root injuries with compression morphology fractures. Although possible, these latter two clinical scenarios are quite rare in the literature and in our experience. In summary, conservative treatment according to the HOE 32020 supplier TLICS was proposed for neurologically intact patients without PLC injury and with AO type A fractures. Borderline injury severity score C the TLICS 4 In the group of patients that can be treated conservatively or surgically, all the patients have type A injuries. All patients have stable burst fractures and are neurologically intact, with.