# Thoracolumbar Injury Classification and Severity (TLICS)

TLICS

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/tlics`
HTML: https://magentlab.com/docs/tlics
Markdown: https://magentlab.com/docs/tlics.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Sum the Vaccaro 2005 Thoracolumbar Injury Classification and Severity (TLICS) score from caller-assigned injury morphology, posterior ligamentous complex integrity, and neurologic status, and return the published 0–10 total and treatment-guidance band.

## When to use

When an agent has already assigned the single most severe traumatic thoracolumbar morphology, PLC status, and neurologic status and needs the published TLICS integer and band (0–3 / 4 / ≥5), not a surgical order, AO spine class, or SINS neoplastic score.

## When not to use

- Not a medical device. magent does not read imaging or examine the patient. Morphology, PLC, and neurologic status are caller-assigned.
- Not a surgical order. Bands 0–3 (nonoperative guidance), 4 (equivocal), and ≥5 (operative guidance) follow Vaccaro 2005 Table 2; they are not an operative command.
- Not AO spine classification. Caller assigns the single most severe morphology and does not sum multiple morphologies.
- Not SINS (neoplastic; Fisher 2010). This tool is Vaccaro 2005 TLICS for traumatic thoracolumbar injury only.

## Formula

```
TLICS = morphology (compression 1, burst 2, translational_rotational 3, distraction 4) + plc (intact 0, suspected_indeterminate 2, injured 3) + neuro (intact 0, nerve_root 2, complete_cord_conus 2, incomplete_cord_conus 3, cauda_equina 3); Vaccaro 2005; max 10; caller assigns the single most severe morphology; bands 0-3 / 4 / ge_5
```

## Citation

[A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status.](https://doi.org/10.1097/01.brs.0000182986.43345.cb)
Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al.
Spine (Phila Pa 1976). 2005;30(20):2325-2333
DOI: [10.1097/01.brs.0000182986.43345.cb](https://doi.org/10.1097/01.brs.0000182986.43345.cb)

## Worked example

### Compression, intact PLC, intact neurology

Given: `morphology=compression, neuro=intact, plc=intact`

1. compression → 1; intact PLC → 0; intact neuro → 0
2. Score = 1 (max 10); tlics_band 0-3


### Distraction, injured PLC, incomplete cord/conus

Given: `morphology=distraction, neuro=incomplete_cord_conus, plc=injured`

1. distraction → 4; injured PLC → 3; incomplete_cord_conus → 3
2. Score = 10 (max 10); tlics_band ge_5


## Also searched as

- TLICS
- thoracolumbar injury classification
- Vaccaro TLICS
- TLICS score
- thoracolumbar injury severity
- posterior ligamentous complex
- Spine Trauma Study Group TLICS
- TLICS morphology PLC neurology

## Parameters

- `morphology` (string, required): Caller-assigned single most severe injury morphology (Vaccaro 2005). compression scores 1; burst scores 2; translational_rotational scores 3; distraction scores 4. Do not sum multiple morphologies. magent does not read imaging.
- `plc` (string, required): Caller-assigned posterior ligamentous complex integrity (Vaccaro 2005). intact scores 0; suspected_indeterminate scores 2; injured scores 3. magent does not examine the patient or read imaging.
- `neuro` (string, required): Caller-assigned neurologic status (Vaccaro 2005). intact scores 0; nerve_root scores 2; complete_cord_conus scores 2; incomplete_cord_conus scores 3; cauda_equina scores 3. magent does not examine the patient.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/tlics`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "morphology": "compression",
      "neuro": "intact",
      "plc": "intact"
    },
    {
      "morphology": "compression",
      "neuro": "intact",
      "plc": "intact"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/tlics

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/tlics",
  "items": [
    {
      "components": [
        {
          "value": "compression",
          "factor": "morphology",
          "points": 1,
          "present": true
        },
        {
          "value": "intact",
          "factor": "plc",
          "points": 0,
          "present": true
        },
        {
          "value": "intact",
          "factor": "neuro",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al.",
        "doi": "10.1097/01.brs.0000182986.43345.cb",
        "id": "vaccaro-2005",
        "pmid": "16227897",
        "source": "Spine (Phila Pa 1976). 2005;30(20):2325-2333",
        "title": "A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status."
      },
      "formula": "tlics",
      "formula_expression": "TLICS = morphology (compression 1, burst 2, translational_rotational 3, distraction 4) + plc (intact 0, suspected_indeterminate 2, injured 3) + neuro (intact 0, nerve_root 2, complete_cord_conus 2, incomplete_cord_conus 3, cauda_equina 3); Vaccaro 2005; max 10; caller assigns the single most severe morphology; bands 0-3 / 4 / ge_5",
      "max_score": 10,
      "score": 1,
      "tlics_band": "0-3"
    },
    {
      "components": [
        {
          "value": "compression",
          "factor": "morphology",
          "points": 1,
          "present": true
        },
        {
          "value": "intact",
          "factor": "plc",
          "points": 0,
          "present": true
        },
        {
          "value": "intact",
          "factor": "neuro",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al.",
        "doi": "10.1097/01.brs.0000182986.43345.cb",
        "id": "vaccaro-2005",
        "pmid": "16227897",
        "source": "Spine (Phila Pa 1976). 2005;30(20):2325-2333",
        "title": "A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status."
      },
      "formula": "tlics",
      "formula_expression": "TLICS = morphology (compression 1, burst 2, translational_rotational 3, distraction 4) + plc (intact 0, suspected_indeterminate 2, injured 3) + neuro (intact 0, nerve_root 2, complete_cord_conus 2, incomplete_cord_conus 3, cauda_equina 3); Vaccaro 2005; max 10; caller assigns the single most severe morphology; bands 0-3 / 4 / ge_5",
      "max_score": 10,
      "score": 1,
      "tlics_band": "0-3"
    }
  ]
}
```

## Response fields

- `formula` (string): tlics
- `formula_expression` (string): Exact expression used
- `score` (integer): Vaccaro 2005 TLICS total 0-10
- `max_score` (integer): 10
- `tlics_band` (string): Vaccaro 2005 Table 2 band: 0-3 (nonoperative guidance), 4 (equivocal), or ge_5 (operative guidance). Not a surgical order.
- `components` (array): Per-factor Vaccaro 2005 points
- `citation` (object): Vaccaro et al. Spine 2005 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": "compression",
      "factor": "morphology",
      "points": 1,
      "present": true
    },
    {
      "value": "intact",
      "factor": "plc",
      "points": 0,
      "present": true
    },
    {
      "value": "intact",
      "factor": "neuro",
      "points": 0,
      "present": true
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al.",
    "doi": "10.1097/01.brs.0000182986.43345.cb",
    "id": "vaccaro-2005",
    "pmid": "16227897",
    "source": "Spine (Phila Pa 1976). 2005;30(20):2325-2333",
    "title": "A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status."
  },
  "formula": "tlics",
  "formula_expression": "TLICS = morphology (compression 1, burst 2, translational_rotational 3, distraction 4) + plc (intact 0, suspected_indeterminate 2, injured 3) + neuro (intact 0, nerve_root 2, complete_cord_conus 2, incomplete_cord_conus 3, cauda_equina 3); Vaccaro 2005; max 10; caller assigns the single most severe morphology; bands 0-3 / 4 / ge_5",
  "max_score": 10,
  "score": 1,
  "tlics_band": "0-3"
}
```

## Errors

- HTTP 400 `invalid_tlics`: morphology must be compression, burst, translational_rotational, or distraction; plc must be intact, suspected_indeterminate, or injured; neuro must be intact, nerve_root, complete_cord_conus, incomplete_cord_conus, or cauda_equina (Vaccaro 2005 TLICS). Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [NEXUS C-spine](https://magentlab.com/docs/nexus) — Apply the Hoffman 2000 NEXUS C-spine rule and return whether the five low-risk criteria all hold (imaging not indicated by this rule).
- [SINS](https://magentlab.com/docs/sins) — Sum the Fisher 2010 Spinal Instability Neoplastic Score from six caller-assigned items and return the published 0–18 integer total. Not later SOSG stability strata and not an operative order.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.