Thoracolumbar fractures are evaluated primarily based on injury morphology,
neurologic status, and integrity of the posterior ligamentous complex. These are included in the TLICS classification system, which can help guide surgical decision making.
History
• Do you have other sites of pain along your spine?
• Do you have any weakness, numbness, or tingling?
Physical Exam
• Trauma evaluation (Appendix A)
• Complete neurologic exam (Appendix A)
Diagnosis
Imaging
• T/L XRs—AP, lateral
• T/L CT—required to evaluate fracture pattern (Fig. 1) • T/L MRI—necessary to evaluate for acute disc herniation or disrupted disco- ligamentous complex