Is the Thoracolumbar AOSpine Injury Score Superior to the Thoracolumbar Injury Classification and Severity Score for Guiding the Treatment Strategy of Thoracolumbar Spine Injuries?

OBJECTIVE: To determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and the Thoracolumbar AOSpine Injury Score (TL AOSIS) have any superiority to each other in terms of the reliability of their recommendations for guiding the treatment strategy of thoracolumbar spine injuries. METHODS: A total of 110 consecutive patients with thoracolumbar injuries hospitalized from January to September 2019 were analyzed retrospectively. The TLICS and the TL AOSIS systems were compared based on patients' therapeutic decisions suggested by each system. RESULTS: A total of 110 patients were studied. The TL AOSIS matched treatment decision-making in 108 patients (98.18%), and the TLICS matched 96 patients (87.27%). Of the patients without neurologic deficit, according to TL AOSIS system, 12 of 62 received >5 points, 12 received 4 or 5 points, and 38 received <4 points. According to TLICS system, 12 of 62 received >= 5 points, 50 received <= 3 points, and none received 4 points. The TL AOSIS matched 60 patients (96.77%), and the TLICS matched 48 patients (77.42%). Of the patients with neurologic deficits, according to TL AOSIS system, 36 of 48 received >5 points, and 12 received 4 or 5 points. According to TLICS system, 22 received >4 points, and 26 received 4 points, and the systems achieved agreement. CONCLUSIONS: Recommendations of TL AOSIS might be more reliable than those of TLICS particularly for guiding the surgical management of complete burst fractures.