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A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Vaccaro AR, Lehman RA, Hurlbert RJ, Anderson PA, Harris M, Hedlund R, et al. AOSpine Classification Syst (Subaxial, Thoracolumbar). Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma. Joaquim AF, Fernandes YB, Cavalcante RAC, Fragoso RM, Honorato DC, Patel AA. Classification of thoracic and lumbar spine fractures: problems of reproducibility. Oner FC, Ramos LMP, Simmermacher RKJ, Kingma PTD, Diekerhof CH, Dhert WJA, et al. The load sharing classification of spine fractures. Sequential damage assessment of the different components of the posterior ligamentous complex after magnetic resonance imaging interpretation. Pizones J, Izquierdo E, Sánchez-Mariscal F, Zúñiga L, Álvarez P, Gómez-Rice A. International standards for neurological classification of spinal cord injury (Revised 2011).
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Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. Shear fracture-dislocations of the thoracic and lumbar spine associated with forceful hyperextension (lumberjack paraplegia). The three column spine and its significance in injury classification of acute thoracolumbar spinal injuries. A concept for the validation of fracture classifications. Do we have an ideal classification system for thoracolumbar and subaxial cervical spine injuries: what is the expert’s perspective? Spinal Cord. AO spine injury classification system: a revision proposal for the thoracic and lumbar spine. Reinhold M, Audigé L, Schnake KJ, Bellabarba C, Dai LY, Oner FC. Kepler CK, Vaccaro AR, Schroeder GD, Koerner JD, Vialle LR, Aarabi B, et al. The thoracolumbar injury severity score: a proposed treatment algorithm. Vaccaro AR, Zeiller SC, Hulbert RJ, Anderson PA, Harris M, Hedlund R, et al. A comprehensive classification of thoracic and lumbar spine injuries. Magerl F, Aebi M, Gertzbein S, Harms J, Nazarian S. An analysis of one hundred consecutive cases a new classification.J Bone Joint Surg Am. McAfee PC, Yuan HA, Fredrickson BE, Lubicky JP.The value of computed tomography in thoracolumbar fractures. A mechanistic classification of thoracolumbar spine fractures. What should an ideal spinal injury classification system consist of? A methodological review and conceptual proposal for future classifications. Van Middendorp JJ, Audigé L, Hanson B, Chapman JR, Hosman AJF. Thoracolumbar spine trauma classification. Classifications of thoracic and lumbar fractures: rationale and supporting data. Mirza SK, Mirza AJ, Chapman JR, Anderson PA. The next phase of validation would involve multicentric reliability studies and prospective application of the SCS- TL fractures.
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The proposed SCS-TL fractures helps in classifying and in decision making for management of TL fractures. In the second stage, there was 100% agreement for the management as well as surgical approach as carried out at our centre and that proposed by the SCS for TL fractures. In the first stage there was 100% agreement for management (conservative or surgical) as proposed by experts and that suggested by the proposed classification for TL fractures whereas for surgical approach there was 88% agreement. Second stage was a one year prospective study analyzing if the management suggested matched the management actually carried out by different spine surgeons ( n = 10) working at a single institution. First stage analyzed if management of 30 cases of TL fractures, as suggested by the SCS - TL fractures and ISCoS STSG ( n = 9) as well as other ( n = 5) experts, matched. After Face and Content validation, Construct validation was done in two stages. Tertiary Spinal Injuries Centre, New Delhi, India Methodsīased on the International Spinal Cord Society Spine Trauma Study Group (ISCoS STSG, n = 23) experts’ clinical consensus conducted by the senior author and on his own experience, the Denis classification for TL fractures was modified to develop a SCS-TL fractures that could guide the management. To develop and validate a Simplified Classification System (SCS) for Thoraco-Lumbar (TL) fractures (SCS – TL fractures). Development and validation of fracture classification system.