Management of thoracolumbar fractures based on TLICS guidelines
Introduction: The TLICS guidelines and anterior approach makes treatment of thoracolumbar fractures more definitive with better correction of sagittal coronal plane, kyphosis, adequate decompression of neural tissue. However, the thoracolumbar junction (T11, T12 and L1) poses an anatomical dilemma, due to diaphragm and the lower rib cage when performing anterolateral approaches7 .
Materials and methods: The purpose of this study is to determine the effectiveness of stabilising the thoraco-lumbar fractures by diaphragm sparing mini open thoracotomy as per TLICS guidelines. Our study presented here in presents a pure clinical series in the form of a prospective cohort study that was applied to 42 consecutive cases of thoracolumbar fracture who were treated between 2013 and 2016 in a tertiary care centre in India. Patients were randomised into observation and surgery groups based on the TLICS guidelines. The patients in the surgery cohort underwent single-level thoracolumbar corpectomies with expandable cage placement through a mini-open thoracotomy approach without any posterior instrumentation. The results of the 2 groups were tabulated and analysed.
Results: The primary outcome was measured by the American Spinal Injury Association Impairment Scale (AIS). This is the second paper to prospectively use the TLICS to guide surgical and nonsurgical care in the treatment of a consecutive series of patients with thoracolumbar spine trauma showing level II evidence according to evidence based medicine criteria proposed by Wright et al.
Key words: thoracolumbar fractures, instability, kyphosis, trauma, collapse, thoracotomy, spinal fractures.
Citation: Lingaraju TS: “Management of thoracolumbar fractures based on TLICS guidelines”. SVOA Neurology 1:1(2020) 10-23.
