ObjectiveTo evaluate the inter and intraobserver agreement of the Magerl AO and AOSpine thoracolumbar fracture classification systems.MethodsThe participants were divided into two groups, the first composed of six spinal surgeons and the other composed of 18 medical orthopedic residents. On two different occasions, separated by an interval of one month, the participants analyzed and classified 25 radiographs with thoracolumbar fractures using both thoracolumbar fracture classification systems, Magerl AO and AOSpine. The results were analyzed for classification reliability using the Kappa coefficient (k).ResultsThe Magerl AO classification system showed a fair interobserver agreement (k = 0.32), considering the fractures type and subtype, whereas the AOSpine classification system showed a moderate interobserver agreement (k = 0.59). The Magerl AO classification showed a fair intraobserver agreement for both residents and specialists (k = 0.21 and 0.38, respectively), while the AOSpine showed a substantial agreement between residents (k = 0.62) and moderate between specialists (k = 0.53).ConclusionsWhen evaluating fracture morphology, the AOSpine thoracolumbar fracture classification system presented a better reliability and reproducibility compared to the Magerl AO classification system.
OBJECTIVE: To compare X-rays usually performed in supine with lateralization with those in lateral decubitus with fulcrum at the apex of the primary curve caused by cushion, in order to monitor the achievement of improvement patterns of correction in preestablished deformities for the preoperative surgical planning. METHODS: Comparison of radiographic studies in the preoperative supine with lateralization and lateral decubitus with cushion performing fulcrum at the apex of the major curve in patients with adolescent idiopathic scoliosis. RESULTS: Curves varied in AP between 76° e 40° and were corrected in supine with lateralization to the average of 21° observing that when carried out with fulcrum with cushion in lateral decubitus the curves were corrected to 15° on average with higher discrepancy in values among the most rigid curves. CONCLUSIONS: It was verified that on flexible curves the cushions did not produce satisfactory corrections in primary curves. In more rigid curves and in collaborative patients, greater effectiveness on the correction of deformity in main curves was obtained with cushions producing local fulcrum for a better preoperative planning on correction of deformities.
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