How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?

The thoracolumbar injury classification and severity score (TLICS) system help surgeons decide whether patients should undergo initial operative treatment or nonoperative treatment. However, the best treatment for patients with TLICS 4 fracture remains unknown. The aim of this study was to identify...

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Autores principales:	Nam-Hun Lee, Sung-Kyu Kim, Hyoung-Yeon Seo, Eric T. Park, Won-Young Jang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	thoracolumbar fracture TLICS 4 treatment nonoperative failure Medicine R
Acceso en línea:	https://doaj.org/article/180d3821cf9745ec9191bb3d45e5ff89
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spelling	oai:doaj.org-article:180d3821cf9745ec9191bb3d45e5ff892021-11-11T17:34:47ZHow Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?10.3390/jcm102149442077-0383https://doaj.org/article/180d3821cf9745ec9191bb3d45e5ff892021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4944https://doaj.org/toc/2077-0383The thoracolumbar injury classification and severity score (TLICS) system help surgeons decide whether patients should undergo initial operative treatment or nonoperative treatment. However, the best treatment for patients with TLICS 4 fracture remains unknown. The aim of this study was to identify the risk factors for nonoperative treatment failure in patients with TLICS 4 fracture and establish treatment standards for TLICS 4 fractures. This study included 44 patients with TLICS 4 fracture who initially received nonoperative treatment. We divided these patients into two groups: the successful nonoperative treatment group included 18 patients, and the operative treatment group after nonoperative treatment failure included 26 patients. In multiple logistic regression analysis, spinal canal compromise (odd ratio = 1.316) and kyphotic angle (odd ratio = 1.416) were associated with nonoperative treatment failure in patients with TLICS 4 fracture. Other factors, including age, sex, BMI, initial VAS score, and loss of vertebral body height, were not significantly associated with nonoperative treatment failure in these patients. Spinal canal compromise and kyphotic angle were associated with nonoperative treatment failure in patients with TLICS 4 fracture. Therefore, we recommend the surgeon observe spinal canal compromise and kyphotic angle more carefully when deciding on the treatment of patients with TLICS 4 fracture.Nam-Hun LeeSung-Kyu KimHyoung-Yeon SeoEric T. ParkWon-Young JangMDPI AGarticlethoracolumbar fractureTLICS 4treatmentnonoperativefailureMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4944, p 4944 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	thoracolumbar fracture TLICS 4 treatment nonoperative failure Medicine R
spellingShingle	thoracolumbar fracture TLICS 4 treatment nonoperative failure Medicine R Nam-Hun Lee Sung-Kyu Kim Hyoung-Yeon Seo Eric T. Park Won-Young Jang How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?
description	The thoracolumbar injury classification and severity score (TLICS) system help surgeons decide whether patients should undergo initial operative treatment or nonoperative treatment. However, the best treatment for patients with TLICS 4 fracture remains unknown. The aim of this study was to identify the risk factors for nonoperative treatment failure in patients with TLICS 4 fracture and establish treatment standards for TLICS 4 fractures. This study included 44 patients with TLICS 4 fracture who initially received nonoperative treatment. We divided these patients into two groups: the successful nonoperative treatment group included 18 patients, and the operative treatment group after nonoperative treatment failure included 26 patients. In multiple logistic regression analysis, spinal canal compromise (odd ratio = 1.316) and kyphotic angle (odd ratio = 1.416) were associated with nonoperative treatment failure in patients with TLICS 4 fracture. Other factors, including age, sex, BMI, initial VAS score, and loss of vertebral body height, were not significantly associated with nonoperative treatment failure in these patients. Spinal canal compromise and kyphotic angle were associated with nonoperative treatment failure in patients with TLICS 4 fracture. Therefore, we recommend the surgeon observe spinal canal compromise and kyphotic angle more carefully when deciding on the treatment of patients with TLICS 4 fracture.
format	article
author	Nam-Hun Lee Sung-Kyu Kim Hyoung-Yeon Seo Eric T. Park Won-Young Jang
author_facet	Nam-Hun Lee Sung-Kyu Kim Hyoung-Yeon Seo Eric T. Park Won-Young Jang
author_sort	Nam-Hun Lee
title	How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?
title_short	How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?
title_full	How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?
title_fullStr	How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?
title_full_unstemmed	How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?
title_sort	how should patients with a thoracolumbar injury classification and severity score of 4 be treated?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/180d3821cf9745ec9191bb3d45e5ff89
work_keys_str_mv	AT namhunlee howshouldpatientswithathoracolumbarinjuryclassificationandseverityscoreof4betreated AT sungkyukim howshouldpatientswithathoracolumbarinjuryclassificationandseverityscoreof4betreated AT hyoungyeonseo howshouldpatientswithathoracolumbarinjuryclassificationandseverityscoreof4betreated AT erictpark howshouldpatientswithathoracolumbarinjuryclassificationandseverityscoreof4betreated AT wonyoungjang howshouldpatientswithathoracolumbarinjuryclassificationandseverityscoreof4betreated
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How Should Patients with a Thoracolumbar Injury Classification and Severity Score of 4 Be Treated?

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