Letter to the Editor: Thoracolumbar Injury Classification and Severity Score

Tong, Yongjun; Wu, Quan-Zhou

doi:10.3171/2014.9.spine14788

Cited by 2 publications

(3 citation statements)

References 27 publications

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“…Despite the widespread use of the TLICS scoring system for evaluating thoracolumbar fractures, it primarily focuses on traumatic thoracolumbar fractures and does not consider osteoporotic factors 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The Thoracolumbar Injury Classi cation and Severity Score (TLICS) classi cation is commonly used to assess the severity of thoracolumbar spinal fractures and determine treatment plans. However, this system primarily applies to traumatic fractures rather than osteoporotic fractures 10 . Osteoporotic fractures and traumatic fractures have distinct characteristics and management plans.…”

Section: Introductionmentioning

confidence: 99%

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A Novel Imaging-Based Scoring System to Predict Progressive Kyphosis and Residual Back Pain Post-Percutaneous Kyphoplasty in Osteoporotic Vertebral Compression Fractures

Jin,

Shang,

et al. 2024

Preprint

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A novel imaging-based scoring system (NIBSS) was developed to assess osteoporotic vertebral compression fractures (OVCFs) and predict progressive kyphosis (PK) and residual back pain (RBP) post-Percutaneous Kyphoplasty (PKP). We conducted a single-center retrospective study involving 129 OVCF patients treated with PKP from January 2020 to December 2022. Patients were categorized into low-score and high-score groups based on NIBSS, revealing significantly lower Vertebral Height Loss (VHL), Kyphosis angle (KA), and VAS/ODI scores in the low-score group (P < 0.05). High-score patients showed increased risk of PK and RBP (OR = 11.323 and OR = 13.591, respectively, P < 0.001). Multivariate analysis identified independent risk factors for PK as NIBSS score, postoperative KA difference, black-liner signal, and postoperative ODI score. Additionally, independent risk factors for RBP were determined to be NIBSS score, postoperative KA, and Type D cement form. Our models exhibited strong discriminative performances (AUC = 0.923 and 0.894). NIBSS emerged as a pivotal predictor for adverse outcomes, advocating for tailored interventions in high-risk patients, such as rigid bracing, active osteoporosis treatment, or even adjunctive internal fixation. This study underscores the clinical utility of NIBSS in guiding treatment decisions and improving patient outcomes post-PKP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Novel Imaging-Based Scoring System to Predict Progressive Kyphosis and Residual Back Pain Post-Percutaneous Kyphoplasty in Osteoporotic Vertebral Compression Fractures

Jin,

Shang,

et al. 2024

Preprint

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“…The Thoracolumbar Injury Classi cation and Severity Score (TLICS) classi cation is commonly used to assess the severity of thoracolumbar spinal fractures and determine treatment plans. This system evaluates thoracolumbar spinal fractures based on the four aspects: type of injury, level of injury, integrity of posterior ligamentous complex and additional Injury [10]. However, this system primarily applies to traumatic fractures rather than osteoporotic fractures.…”

mentioning

confidence: 99%

A New Assessment System of Osteoporotic Vertebral Compression Fractures: A Retrospective Study

Cong

Zhen

et al. 2023

Preprint

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Background We have developed a new scoring system that specifically designed for osteoporotic vertebral compression fractures (OVCFs) to guide treatment selection. This system evaluates four aspects: fracture type, fracture morphology, MRI signal changes, and bone mineral density. Methods From March 2016 to March 2021, we conducted a retrospective study of radiographic and clinical data from 208 patients who underwent conservative treatment for OVCFs. Based on the new assessment system of osteoporotic vertebral compression fractures (NASOVCF) scores, the patients were divided into low (48 cases), medium (108 cases), and high (52 cases) score groups. We compared the visual analog scale (VAS), Oswestry Disability Index (ODI) scores, vertebral height loss, kyphosis angle, and bone union rate among the three groups. Logistic regression analysis was used to determine the relationship between bone non-union and independent variables. Results The low-score group showed significantly lower VAS and ODI scores both before treatment and at the follow-up compared to the medium-score and high-score groups (P < 0.05). Additionally, the low-score group had significantly lower vertebral height loss and kyphosis angle differences compared to the medium-score and high-score groups. The bone union rate in the low-score group was 97.9%, which was significantly higher than the rates of 75% in the medium-score group and 32.7% in the high-score group. The high-score group had a significantly higher risk of non-union compared to the low-score group (OR = 88.78; P = 0.001) and the medium-score group (OR = 15.67; P = 0.001). Additionally, female gender (OR = 3.20, P = 0.014), ODI at pre-treatment (OR = 1.11, P = 0.009), and NASOVCF score (OR = 2.59, P = 0.000) were identified as independent risk factors for bone non-union. Conclusions Based on the NASOVCF scoring system, the low-score group showed superior outcomes in terms of pain relief, functional improvement, prevention of vertebral height loss and worsening spinal kyphosis, as well as a higher bone union rate, compared to the medium-score and high-score groups. Therefore, conservative treatment is recommended for OVCF patients with a score of 3 or less, while surgical treatment is recommended for patients with a score of 7 or higher.

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Letter to the Editor: Thoracolumbar Injury Classification and Severity Score

Cited by 2 publications

References 27 publications

A Novel Imaging-Based Scoring System to Predict Progressive Kyphosis and Residual Back Pain Post-Percutaneous Kyphoplasty in Osteoporotic Vertebral Compression Fractures

A Novel Imaging-Based Scoring System to Predict Progressive Kyphosis and Residual Back Pain Post-Percutaneous Kyphoplasty in Osteoporotic Vertebral Compression Fractures

A New Assessment System of Osteoporotic Vertebral Compression Fractures: A Retrospective Study

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