Figure 1

Illustrative case of TLISS use. Patient is an 18 y/o male who presents after a motor vehicle accident. Representative sagittal (A), coronal (B) and axial (C) computed tomography images were obtained. A compression fracture with angular deformity at T5 combined with a significant rotational injury is evident. Only the highest scoring injury, the translational/rotational score, is used for morphology (3 points). CT imaging suggests posterior ligamentous disruption due to severity of rotational deformity at the fracture site, and a palpable step between spinous processes on physical exam confirmed PLC injury (3 points). The patient was neurologically intact (0 points). The comprehensive score of 6 suggests operative therapy. An intact patient with disrupted PLC favors a posterior approach in the treatment algorithm [6]. The patient was treated with a multilevel posterior stabilization and fusion.