Vaccaro, Spine (Phila Pa 1976) 2013 - Aospine Thoracolumbar Spine Injury Classification System: Fracture Description, Neurological Status, and Key Modifiers

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Aospine Thoracolumbar Spine Injury Classification System: Fracture Description, Neurological Status, and Key Modifiers

Vaccaro, AOSpine Spinal Cord Injury & Trauma Knowledge Forum, et al.·Spine (Phila Pa 1976)·2013·881 citations·Diagnostic study

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Background

Although the Magerl classification and thoracolumbar injury classification system (TLICS) are both well-known schemes to describe thoracolumbar (TL) fractures, no TL injury classification system has achieved universal international adoption. This lack of consensus limits communication between clinicians and researchers complicating the study of these injuries and the development of treatment algorithms.

Purpose

To develop a widely accepted, comprehensive yet simple classification system with clinically acceptable intra- and interobserver reliability for use in both clinical practice and research.

Methods

Study Design: Reliability and agreement study, retrospective case series.

A simple and reproducible classification system of TL injuries was developed using a structured international consensus process.
This classification system consists of a morphologic classification of the fracture, a grading system for the neurological status, and description of relevant patient-specific modifiers.
40 cases with a broad range of injuries were classified independently twice by group members 1 month apart and analyzed for classification reliability using the Kappa coefficient (K).

Results

The morphologic classification is based on 3 main injury patterns: type A (compression), type B (tension band disruption), and type C (displacement/translation) injuries.
Reliability in the identification of a morphologic injury type was substantial (K = 0.72).

Conclusions

The AOSpine TL injury classification system is clinically relevant according to the consensus agreement of our international team of spine trauma experts. Final evaluation data showed reasonable reliability and accuracy, but further clinical validation of the proposed system requires prospective observational data collection documenting use of the classification system, therapeutic decision making, and clinical follow-up evaluation by a large number of surgeons from different countries.

Copyright remains with the authors and publisher.

Aospine Thoracolumbar Spine Injury Classification System: Fracture Description, Neurological Status, and Key Modifiers.

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Aospine Thoracolumbar Spine Injury Classification System: Fracture Description, Neurological Status, and Key Modifiers

Vaccaro, AOSpine Spinal Cord Injury & Trauma Knowledge Forum, et al.·Spine (Phila Pa 1976)·2013·881 citations·Diagnostic study

|

Background

Although the Magerl classification and thoracolumbar injury classification system (TLICS) are both well-known schemes to describe thoracolumbar (TL) fractures, no TL injury classification system has achieved universal international adoption. This lack of consensus limits communication between clinicians and researchers complicating the study of these injuries and the development of treatment algorithms.

Purpose

To develop a widely accepted, comprehensive yet simple classification system with clinically acceptable intra- and interobserver reliability for use in both clinical practice and research.

Methods

Study Design: Reliability and agreement study, retrospective case series.

A simple and reproducible classification system of TL injuries was developed using a structured international consensus process.
This classification system consists of a morphologic classification of the fracture, a grading system for the neurological status, and description of relevant patient-specific modifiers.
40 cases with a broad range of injuries were classified independently twice by group members 1 month apart and analyzed for classification reliability using the Kappa coefficient (K).

Results

The morphologic classification is based on 3 main injury patterns: type A (compression), type B (tension band disruption), and type C (displacement/translation) injuries.
Reliability in the identification of a morphologic injury type was substantial (K = 0.72).

Conclusions

The AOSpine TL injury classification system is clinically relevant according to the consensus agreement of our international team of spine trauma experts. Final evaluation data showed reasonable reliability and accuracy, but further clinical validation of the proposed system requires prospective observational data collection documenting use of the classification system, therapeutic decision making, and clinical follow-up evaluation by a large number of surgeons from different countries.

Copyright remains with the authors and publisher.

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