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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2025; 35(04): 529-539
DOI: 10.1055/s-0045-1805025
Review Article

Spine Trauma Classifications: Historical, Current, and Emerging Perspectives for Radiologists

Authors

  • Khanak Nandolia

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

  • Sonal Saran 

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

  • Garima Varshney

    1   Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

  • Kapil Shirodkar

    2   Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom

  • Karthikeyan P. Iyengar 

    3   Department of Orthopaedics, Southport and Ormskirk Hospitals, National Health Service Trust, Southport, United Kingdom

  • Rajesh Botchu

    2   Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, United Kingdom

Funding None.
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Abstract

The spine serves as a protective, load-bearing, and stabilizing axis for the body. Trauma can cause significant damage to spinal structures, potentially resulting in severe neurological dysfunction and disabilities such as paraplegia or quadriplegia. Early and accurate diagnosis of these injuries is important, with computed tomography and magnetic resonance imaging being important for recognizing these injuries and guiding timely treatment to minimize disability. Radiologists play a critical role in assessing spine trauma to determine stability, which informs the need for nonoperative or operative management. Trauma classification systems are vital for uniform communication between radiologists and surgeons, aiding in decision-making. Various classifications exist for cervical, thoracolumbar, and sacral trauma, each with advantages and limitations. Understanding these classification systems is essential for guiding diagnosis, treatment, and prognostication. Over the years, these systems have evolved, reflecting advancements in medical knowledge, imaging technology, and clinical practices. Contemporary classification systems have addressed the limitations of previous systems. Vaccaro et al proposed the “Thoracolumbar Injury Classification and Severity Score (TLICS)” in 2005 and the “Subaxial Cervical Spine Injury Classification System” in 2007. These classifications focus on injury morphology, the integrity of the posterior ligamentous complex or discoligamentous complex, and the patient's neurologic status. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) founded the “Spine Classification Group” to review the “AO-Magerl classification” and create an extensive system for the whole spine. This system focuses on fracture morphology, neurological status, clinical modifiers, and facet joint injury. The TLICS system is straightforward and easy to use in clinical practice, while the AOSpine system is more comprehensive and reliable. As classification systems evolve, collaboration among radiologists, spine surgeons, and researchers will be essential. By embracing advancements in imaging technology and incorporating new clinical data, the field of spine trauma classification can achieve greater accuracy and consistency, ultimately enhancing patient care and outcomes.

Keywords

spine trauma - TLICS - AO - CT - MRI

Authors' Contributions

K.N.: Original draft preparation.

S.S.: Conceptualization, reviewing, editing, and supervision of the work.

G.V., K.S., and K.P.I.: Resources, writing—review, and editing processes.

R.B.: Revision after reviewing by co-authors.

All authors approved the final version before submission.




Publikationsverlauf

Artikel online veröffentlicht:
27. Februar 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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