The Application Study of 64-slice Spiral CT in TLICS Classification System for Thoracolumbar Injury

Objective: To investigate application values of the Thoraco-Lumbar Injury Classification and Severity (TLICS) Classification System in thoracolumbar injury by using 64-slice spiral CT scan, multi-planar reconstruction (MPR) and three-dimensional volume reconstruction (VR). Materials and Methods: The retrospective study included 50 patients (27 males and average ages were 44±9.8) with thoracolumbar injury from October 2014 to October 2016. All patients were scanned by 64-slice spiral CT and performed the sagittal MPR and three-dimensional VR for imaging diagnosis. Then we evaluated the severity of posterior ligamentous complex (PLC) injury according to the typical CT features of thoracolumbar injury. When the TLICS score was higher than 4, we compared the CT features with surgical findings. Results: Seventy-six vertebral fractures were checked out in all 50 patients, included 18 compressed fractures, 28 burst fractures, 20 translation/rotation fractures, and 10 stretch fractures. In addition, 14 patients were found the PLC injuries with different CT imaging features, i.e. 5 avulsion fractures of spinous process, 3 translational and rotational malformation of centrum, 2 transverse fractures of articular process, 2 cases with facet dislocation, 2 broadened interspinous space complicated with facet dislocation and fracture of articular process respectively. Conclusions: Combined MPR and three-dimensional VR could effectively detect fractures and dislocations features indicating the injury of PLC. MPR and VR can be applied as the significant diagnostic examination method, especially to the emergency patients, which could be used for early clinical application of TLICS classification system.