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Review Paper | Surgery | Volume 15 Issue 7, July 2026 | Pages: 257 - 261 | India
TLICS-R and Comprehensive Spine Injury Classification: A Literature-Derived Framework for Modern Spine Trauma Decision-Making
Abstract: Spine trauma classification systems are essential for communication, treatment planning, prognostication, audit, and research. The Thoracolumbar Injury Classification and Severity Score (TLICS), Subaxial Cervical Spine Injury Classification (SLIC), AO Spine classifications, and ASIA neurological grading remain widely used, but each has limitations. Conventional TLICS is clinically practical but incompletely captures quantitative radiographic instability, host biology, posterior ligamentous complex uncertainty, osteoporotic failure risk, ankylosed-spine behavior, frailty, and dynamic reassessment. This narrative review proposes an integrated model in which TLICS-R functions as a thoracolumbar module within a broader Comprehensive Spine Injury Classification System (CSICS). The framework preserves established systems while adding radiographic risk, host modifiers, posterior ligamentous complex confidence grading, neurological MRI severity using the BASIC score, surgical-risk tiering, damage-control considerations, outcome profiling, and an artificial intelligence-ready quantification layer. Existing literature permits construct-level and component-level validation: published studies support the clinical relevance of kyphosis, sagittal index, vertebral height loss, canal compromise, interpedicular widening, osteoporosis, ankylosed spine, MRI-based ligamentous assessment, cord signal severity, frailty, and conservative-treatment failure in grey-zone thoracolumbar injuries. However, the combined scoring weights, cutoffs, and treatment thresholds require patient-level retrospective derivation, interobserver reliability testing, external validation, and prospective multicenter assessment. TLICS-R/CSICS should therefore be regarded as a literature-supported classification proposal and validation roadmap rather than a validated replacement for existing systems.
Keywords: spine trauma, thoracolumbar fracture, TLICS, classification, posterior ligamentous complex
How to Cite?: Dr. Nishant, "TLICS-R and Comprehensive Spine Injury Classification: A Literature-Derived Framework for Modern Spine Trauma Decision-Making", Volume 15 Issue 7, July 2026, International Journal of Science and Research (IJSR), Pages: 257-261, https://www.ijsr.net/getabstract.php?paperid=SR26630091922, DOI: https://dx.doi.org/10.21275/SR26630091922