Validated algorithmic approach to thoracic and lumbar spinal column stability.
Thoracolumbar Stability Probe
Input the injury morphology, PLC status, and neurological findings to determine the TLICS stability score.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Surgical decision making for acute fractures of the Thoracic or Lumbar spine.
Crucial tool in trauma bays to defend conservative management by bracing versus rapid operative pedicle screw fixation.
Section 2
Literature
Development
Like its cervical sibling (SLIC), the TLICS system was developed by Vaccaro and the Spine Trauma Study Group (2005) to replace complex semantic classifications (Denis columns, AO classes) with a purely functional, points-based algorithm dictating treatment.
Section 3
Pearls/Pitfalls
The PLC Disruption
Notice that a completely disrupted Posterior Ligamentous Complex (PLC) yields 3 points. Bone heals, but ligaments do not. Therefore, a purely ligamentous injury often necessitates surgical hardware fusion more urgently than a comminuted burst fracture where the bone and ligaments remain geometrically aligned.
Section 4
Evidence Appraisal
Primary Reference
A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status
Vaccaro AR et al. • Spine (Phila Pa 1976). 2005;30(20):2325-33
