Spinal instability as defined by the three-column spine concept in acute spinal trauma.

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Abstract

[Indexed for MEDLINE] 13. J Korean Neurosurg Soc. 2015 Mar;57(3):174-7. doi: 10.3340/jkns.2015.57.3.174. Epub 2015 Mar 20. Applicability of thoracolumbar injury classification and severity score to criteria of korean health insurance review and assessment service in treatment decision of thoracolumbar injury. Choi HJ(1), Kim HS(1), Nam KH(1), Cho WH(1), Choi BK(1), Han IH(1). Author information: (1)Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. OBJECTIVE: For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. METHODS: Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. RESULTS: According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score