| Summary: | Purpose of review: Many thoracolumbar injury-classification schemes have been proposed, but a widely accepted and reliable system to characterize injuries and guide treatment has not been established.Recent findings: Recent studies have shown that the most widely used classifications do not produce consistent classification of injuries and have marginal reliability for clinical and research use. In addition, most classification systems do not provide an algorithm to guide treatment. As a result, the Spine Trauma Study Group has attempted to develop a new classification system that would reliably describe an injury and assist in guiding treatment. Studies of the initial version of this classification system showed encouraging results in predicting operative and nonoperative management, but marginal reliability in some areas of the classification prompted continued refinement. The most recent version to date is now referred to as the Thoracolumbar Injury Classification and Severity Score, which scores injuries based on fracture morphology, integrity of posterior ligamentous complex, and neurological status.Summary: Creation of an ideal thoracolumbar classification remains difficult. The Thoracolumbar Injury Classification and Severity Score has been developed with the hope of improving the reliability of thoracolumbar fracture classification and providing a classification that guides treatment.
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