Diagnostic accuracy and clinical utility of mTLICS versus TLICS and TL AOSIS in stratifying three-tier treatment for thoracolumbar injuries: focus on intermediate score range

The mTLICS demonstrated improved accuracy in stratifying thoracolumbar injuries across three treatment tiers and enhanced clarity in decision-making for intermediate cases. Its MRI-based components support personalized, image-guided management. Nonetheless, as clinicians at the study site were familiar with the mTLICS framework through prior academic exposure, potential incorporation bias cannot be entirely excluded. These findings should therefore be interpreted with caution, as mTLICS scores were calculated retrospectively after treatment completion and were not used prospectively to determine patient management, underscoring the need for prospective, multicenter validation to confirm its generalizability.