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Numerous classification systems have been developed over the years to describe thoracolumbar injuries, each with their own benefits and limitations. None of these systems have been accepted however, as a universal, comprehensive system to classify these injuries. The AOSpine Thoracolumbar Injury Classification System has recently been developed in order to overcome some of the limitations of previous systems. An injury severity scoring system based on this system would be beneficial to clinicians when treating these complex injuries. This paper will review thoracolumbar injury classification systems, and describe the need for a new severity scoring system based on the AOSpine Thoracolumbar Injury Classification System.