Editing Openai/69525f34-c274-8008-8a68-a50fa8d68cd8


{{DISPLAYTITLE:Thoracolumbar Injury Classification}}

''This conversation was exported from ChatGPT''<ref>{{cite web|title=Thoracolumbar Injury Classification|url=https://chatgpt.com/share/69525f34-c274-8008-8a68-a50fa8d68cd8|publisher=ChatGPT|access-date=2025-12-30}}</ref>

== gpt-5-2 ==
=== User: Thoracolumbar Injury Classification and ===
Thoracolumbar Injury Classification and 
Severity

=== Assistant: Thoracolumbar Injury Classification and Severity Score TLICS ===
==== Thoracolumbar Injury Classification and Severity Score (TLICS) ====

!https://radiologyassistant\.nl/assets/spine\-injury\-tlics\-classification/a54c216784651b\_9j\-TAB\-overview\.png<ref>{{cite web|title=https://radiologyassistant\.nl/assets/spine\-injury\-tlics\-classification/a54c216784651b\_9j\-TAB\-overview\.png|url=https://radiologyassistant.nl/assets/spine-injury-tlics-classification/a54c216784651b_9j-TAB-overview.png|publisher=radiologyassistant.nl|access-date=2025-12-30}}</ref>
!https://www\.researchgate\.net/publication/379535527/figure/fig4/AS%3A11431281283975881%401729043687442/MRI\-findings\-of\-complete\-posterior\-ligamentous\-complex\-injury\-A\-B\-complete\-PLC\.jpg<ref>{{cite web|title=https://www\.researchgate\.net/publication/379535527/figure/fig4/AS%3A11431281283975881%401729043687442/MRI\-findings\-of\-complete\-posterior\-ligamentous\-complex\-injury\-A\-B\-complete\-PLC\.jpg|url=https://images.openai.com/thumbnails/url/eW8a-nicu5mVUVJSUGylr5-al1xUWVCSmqJbkpRnoJdeXJJYkpmsl5yfq5-Zm5ieWmxfaAuUsXL0S7F0Tw5yDAxzy9X1Dwj19E4tjzSs8MvVjQiqjCpz9U3yT4nPL85Lqwjzcc2MMDMpi_cyNkrzVSsGAH79Jl8|publisher=images.openai.com|access-date=2025-12-30}}</ref>
!https://prod\-images\-static\.radiopaedia\.org/images/18979/72c9b4c7b122501e57f63da52f0e1e\_gallery\.jpeg<ref>{{cite web|title=https://prod\-images\-static\.radiopaedia\.org/images/18979/72c9b4c7b122501e57f63da52f0e1e\_gallery\.jpeg|url=https://prod-images-static.radiopaedia.org/images/18979/72c9b4c7b122501e57f63da52f0e1e_gallery.jpeg|publisher=prod-images-static.radiopaedia.org|access-date=2025-12-30}}</ref>
4
نظام TLICS هو النظام الأهم والأكثر اعتمادًا حاليًا لتقييم Thoracolumbar spine trauma، لأنه لا يكتفي بالوصف التشريحي، بل يربط التصنيف مباشرة بقرار العلاج.
يعتمد على 3 محاور أساسية، وكل محور له Score، والمجموع النهائي يوجّه القرار العلاجي.

==== 1️⃣ Injury Morphology (شكل الإصابة) ====

يُحدَّد أساسًا من CT scan، وأحيانًا MRI.

===== ▪ Compression injury – Score 1 =====
* Loss of anterior vertebral body height
* Stable غالبًا
* Examples: simple wedge fracture

===== ▪ Burst fracture – Score 2 =====
* Posterior wall involvement
* Risk of canal compromise
* Stability depends on PLC

===== ▪ Translation / Rotation injury – Score 3 =====
* Horizontal displacement أو rotation
* Highly unstable
* Indicates severe ligamentous disruption

===== ▪ Distraction injury – Score 4 =====
* Failure under tension
* Seen in flexion-distraction injuries (Chance fracture)

📌 Exam pearl:
Translation/rotation أخطر من burst، وdistraction أخطرهم جميعًا من ناحية instability.

==== 2️⃣ Posterior Ligamentous Complex (PLC) ====

يتكوّن من:
* Supraspinous ligament
* Interspinous ligament
* Ligamentum flavum
* Facet joint capsules

يُقيَّم أساسًا بـ MRI.

===== ▪ Intact – Score 0 =====
* No edema, normal alignment

===== ▪ Indeterminate / suspected – Score 2 =====
* Subtle edema
* Equivocal MRI findings

===== ▪ Disrupted – Score 3 =====
* Clear discontinuity
* Widened interspinous distance
* Facet dislocation

📌 High-yield جدًا:
PLC injury = game changer → غالبًا surgery حتى لو fracture شكله بسيط.

==== 3️⃣ Neurological Status ====

===== ▪ Intact – Score 0 =====

===== ▪ Nerve root injury – Score 2 =====

===== ▪ Complete spinal cord injury – Score 2 =====
* Surgery لا تحسّن neurological outcome
* لكن قد تُجرى لأسباب stability/pain

===== ▪ Incomplete spinal cord injury – Score 3 =====
* Strong indication for surgery

===== ▪ Cauda equina syndrome – Score 3 =====
* Surgical emergency

📌 Exam pearl:
Incomplete cord injury أخطر من complete من حيث decision making → surgery indicated.

==== 📊 Total TLICS Score & Treatment Decision ====

===== 🔹 Score ≤ 3 =====

➡️ Non-operative treatment
* Brace
* Mobilization
* Close follow-up

===== 🔹 Score = 4 =====

➡️ Gray zone
* Surgeon judgment
* Patient factors
* Radiology details

===== 🔹 Score ≥ 5 =====

➡️ Operative management
* Posterior instrumentation ± decompression
* Sometimes anterior reconstruction

==== Clinical مثال سريع (امتحاني): ====
* Burst fracture (2)
* PLC disrupted (3)
* Neurologically intact (0)

👉 Total = 5 → Surgery

==== Why TLICS مهم جدًا في الامتحانات؟ ====
* Decision-based system
* Easy MCQs
* Frequently asked in: - FRCS - Arab Board - Orthopaedic trauma exams

==== References (High-yield): ====
* Orthobullets – Thoracolumbar Spine Trauma
* AAOS Spine Trauma Guidelines
* Vaccaro et al., Spine, TLICS original description

لو حابب:
* أعمل MCQs مباشرة على TLICS
* أو Cases with CT/MRI and scoring step-by-step
* أو مقارنة سريعة بين TLICS vs AO Spine Classification

قولّي وتابع معايا، يا محمد 👌

== References ==
<references />


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