Surgical Decision Making for Thoracolumbar Spine Injuries in Polytrauma Patients

The management of thoracolumbar spine injuries in patients with multiple traumatic injuries is a challenge complicated by multiple competing medical and surgical demands. Safe and effective treatment of polytrauma patients with a thoracolumbar spine injury requires a multidisciplinary approach that involves surgical and critical care teams. The Thoracolumbar Injury Classification and Severity Score, which was developed to facilitate consistent surgical decision making in patients with a thoracolumbar spine injury, provides objective criteria for the classification and management of thoracolumbar spine injuries. The AOSpine study group recently developed a comprehensive thoracolumbar injury classification system that was subsequently used to create the Thoracolumbar AOSpine Injury Score, which helps guide thoracolumbar spine injury management via objective criteria. These scoring systems have been effectively used in clinical practice and allow for a focused and objective assessment of thoracolumbar spine injuries. Both the Thoracolumbar Injury Classification and Severity Score and the Thoracolumbar AOSpine Injury Score should be routinely used in treatment decision making to optimize outcomes and avoid unnecessary surgical treatment in polytrauma patients with a thoracolumbar spine injury.