AOSpine Thoracolumbar Spine Injury Classification System

Vaccaro, Alexander R.; Oner, F. Cumhur; Kepler, Christopher K.; Dvorak, Marcel F.; Schnake, Klaus John; Bellabarba, Carlo; Reinhold, M.; Aarabi, Bizhan; Kandziora, Frank; Chapman, Jens R.; Rajasekaran, Shanmuganathan; Fehlings, Michael G.; Vialle, Luiz Roberto

doi:10.1097/brs.0b013e3182a8a381

Cited by 667 publications

(320 citation statements)

References 25 publications

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“…Each part started with a general case, representing a spinal trauma case after conservative or operative treatment (''Appendix 1''), followed by a predefined compilation of 16 clinical and radiological parameters (''Appendix 2''). These parameters were based on: (1) parameters identified in the systematic literature review of AOSpine PROST development, [11], (2) parameters used by the AOSpine Thoracolumbar Spine Injury Classification System, [12] and (3) expert interviews among three spine surgeons from a level-1 trauma center. Participants of the survey were asked to indicate the relevance of each parameter for the clinical and functional outcome of adult (C18 years) patients who suffered an acute traumatic injury to the thoracic, thoracolumbar or lumbar spine, both for the short-term (3 months-2 years) and long-term (C2 years) post-trauma on a five-point scale: 'definitely not relevant', 'probably not relevant', 'possibly relevant', 'probably relevant', and 'definitely relevant'.…”

Section: Survey Instrumentmentioning

confidence: 99%

Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients

et al. 2016

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Purpose Besides a patient reported outcome measure, the AOSpine Knowledge Forum Trauma aims to develop a new concept of a surgeon reported outcome measure (SROM) for spine trauma patients. This study aims to identify parameters that spine surgeons consider relevant to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients. Methods An international cross-sectional web-based survey was conducted among spine surgeons from the five AOSpine International world regions. They were asked to evaluate the relevance of a compilation of 16 clinical and radiological parameters for thoracic and lumbar spine trauma patients, both for the short term (3 months-2 years) and long term (C2 years), on a five-point scale. The responses were analyzed using descriptive statistics, frequency analysis, and Kruskal-Wallis test.Results Out of the 279 invited members of AOSpine International and the International Spinal Cord Society, 118 (42.3 %) participated in this study. Of the 16 surveyed parameters, 5 were identified as relevant by at least 70 % of the participants. Neurological status was identified as most relevant. In contrast, five parameters were not deemed relevant for any spine region or time period, except for comorbidity. Only minor differences were observed when analyzing the responses according to each world region, spine surgeons' clinical experience, or professional background. Conclusions Including a large and representative sample of spine trauma experts, this study identified parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients. The results form the basis for the development of a SROM for this specific patient population.

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Section: Survey Instrumentmentioning

confidence: 99%

Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients

et al. 2016

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“…This discussion of treatment lacked detail and failed to provide guidance for clinical decision-making [6]. Additionally, although Magerl et al acknowledged the correlation between the level of injury severity and the frequency of neurological deficit, the system failed to offer concrete information about how the increased likelihood of neurological injury and the existence of additional clinical factors and comorbidities should impact the choice of treatment [13]. Another potential issue with this system is the confusion caused by transitional type injuries that span several categories in the classification.…”

Section: Magerl Classification Systemmentioning

confidence: 99%

“…The Magerl classification system, created in 1994, is arguably the most detailed, complex, and systematic spinal trauma classification system [13]. The system, based on the 3-3-3 scheme of the AO fracture classification, distinguishes three main types by the injury morphology: type A (vertebral body compression), type B (distraction), and type C (rotation due to axial torque) [14].…”

Section: Magerl Classification Systemmentioning

confidence: 99%

“…Therefore, TLICS is a guide towards the appropriate treatment, but not a replacement for a surgeon's intuition [6]. There has been criticism over the fact that TLICS may not be applicable in every and all cultures and regions, especially in areas where MRI is not available [13]. Some argued that the severity scoring system did not necessarily reflect universal surgical practices or the most sensible and realistic method of treatment [13].…”

Section: Tlicsmentioning

confidence: 99%

“…Although this system is comprehensive, many argue that it is probably overly complex, creating unnecessary confusion for clinicians and researchers alike [6,13]. The Magerl system discusses 17 different type A injuries, 15 different type B injuries, and 23 different type C injuries.…”

Section: Magerl Classification Systemmentioning

confidence: 99%

See 2 more Smart Citations

Thoracolumbar Injury Severity Scoring Systems: A Review and Rationale for a New System Based on the AOSpine Thoracolumbar Injury Classification System

Koerner¹

2015

Int J Phys Med Rehabil

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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.

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A novel radiological assessment to identify acute vertebral compression fractures: A pilot observational study

Tsuruta,

Ueyama,

Watanabe

et al. 2023

Acute Medicine & Surgery

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AimThe diagnosis of acute vertebral compression fractures (AVCFs) is often challenging. An alternative to magnetic resonance imaging, which may not always be available, includes a comparison of supine and sitting/standing position radiographs. However, this cannot be accomplished in patients with acute vertebral compression fractures who require emergency transport and are in severe pain. In this study, aimed to assess the diagnostic accuracy of comparing lateral‐view radiographs of the thoracolumbar spine in supine and 30° head‐elevated positions, which are less painful.MethodsWe retrospectively examined 30 patients with AVCFs who were transported by ambulance to our emergency department between June 2018 and May 2019. All underwent 30° head‐elevated lateral‐view thoracolumbar spine radiography and magnetic resonance imaging. We evaluated vertebral fractures by examining changes in vertebral wedging ratio (WR) from supine to 30° head‐elevated position (Δ WR) using the following equation: Δ WR = WR (30° head‐elevated) – WR (supine). We compared Δ WR to that of unfractured vertebrae as control.ResultsA total of 176 vertebrae were included (fractured, 32 and non‐fractured, 144). Δ WR of fractured vertebrae ranged between 5.1% and 24.4%, whereas non‐fractured vertebrae ranged between −6.7% and 4.3%. Median Δ WR of fractured vertebrae was significantly higher than non‐fractured vertebrae (12.6% versus −0.5%, p < 0.001). No patients reported pain during 30° head‐elevated positioning.ConclusionsLateral radiographs in supine and 30° head‐elevated positions can accurately diagnose of AVCF, without worsening pain. This study showed a Δ WR value of ≥5.1% for AVCFs.

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AOSpine Thoracolumbar Spine Injury Classification System

Cited by 667 publications

References 25 publications

Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients

Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients

Thoracolumbar Injury Severity Scoring Systems: A Review and Rationale for a New System Based on the AOSpine Thoracolumbar Injury Classification System

A novel radiological assessment to identify acute vertebral compression fractures: A pilot observational study

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