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The Radiology Assistant : Spine injury – TLICS Classification
The anterior longitudinal ligament is disrupted. A distraction injury is separation or pulling apart of two adjacent vertebrae. The role of the radiologist is to report the following: The Holmberg and Gartland classifications had a mean correlation coefficient of 0.
Often unilateral or bilateral facet dislocation is seen in rotational fractures. In this case fractuas are not sure. In this case some would call this a burst fracture with PLC-injury i. Neurological status The third category is the neurological status as determined by the neurologist or spine surgeon. A problem with classifications such as the AO-classification is that they are usually complex, leading to high inter-reader variability.
Clasificacion AO de Muller para fracturas de los huesos largos
There is major disruption of the PLC of both the ligamenta flava and the interspinous ligament. After a fall on his back no fracture was seen on the x-rays. The morphology is burst 2 points The PLC is injured with a fracture through the adjacent spinous processes. A torn PLC has a tendency not to heal and can lead to progressive kyphosis and collapse. Avulsion fractures or transverse fractures of spinous processes or articular facets.
A total of more than 4 points indicates surgical treatment. Notice that on a 2.
Spine injury – TLICS Classification
The key point in this case is that you should not describe this morphology as burst – 2 points. Torn flaval ligament yellow arrow. There is widening between the spinous processes. Distraction- 4 points PLC: If the distraction is the main feature, then the morphology is distraction, i.
AO/OTA Fracture and Dislocation Classification Compendium
The mean correlation coefficient of the AO classification was 0. The difference between the correlation coefficients was 0.
So be sure not to underestimate the injury by only looking at the compression fracture and overlooking the distraction injury. First look at the first CT-images and decide what is going on.
Some of the injuries thought to be due to extension mechanisms, however, turn out to be due to flexion and vice versa. The interspinous ligaments are weak, thin, membranous structures connecting the adjacent spinous processes. Only the level with the highest score counts.
Retropulsion of a body fragment and the percentage of narrowing of the spinal canal.
Here a fracture that just looks like another compression fracture on the lateral view. Minimal anterior displacement of the upper vertebral body. The facet joints are separated on both sides.
TLICS score based on imaging is 7 points. This is an interesting case since non-surgical management was initially attempted in this patient. Translation – Rotation This type of fracture includes all fractures that are the result of displacement in the horizontal plane: When there are several fractures, each level has to be scored separately.
Sternum fracture The image shows a vertebral fracture with a transverse fracture of the spinous process, but also a fracture of the sternum. The morphology is of a vertebral fracture with retropulsion of a fragment, i. In some cases it clasifiacion be difficult to decide whether there is a translation or distraction injury and we have to assume that the traumtic mechanism is a combination of forces. Now when you look carefully at the lateral view, you will notice that the facets are separated.