Operative Treatment of Thoracolumbar Burst Fractures: Is Fusion Necessary?

Fu, Michael C.; Nemani, Venu M.; Albert, Todd J.

doi:10.1007/s11420-015-9439-7

Cited by 10 publications

(1 citation statement)

References 8 publications

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“…Coherent, clear, and high-quality guidelines to classify, assess, and manage patients with TST are therefore essential to optimizing outcomes in spinal injuries as a whole, and to ease the global health burden resulting from these injuries. However, there remains a lack of clear consensus on many aspects of care in TST patients, including classification and radiological evaluation, treatment of blood pressure dysregulation and associated spinal cord injury, nonoperative vs. operative management, and optimal operative standard of care [ 1 - 3 , 5 , 30 - 35 ]. Before these clinical guidelines were released by the AANS/CNS, no universally applicable and accepted evidence-based guidelines on the management of TST were available.…”

Section: Discussionmentioning

confidence: 99%

A Critical Appraisal of the Congress of Neurological Surgeons Evidence-Based Guidelines on the Evaluation and Treatment of Patients With Thoracolumbar Spine Trauma

Makaram,

Liang,

et al. 2024

Cureus

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Background and objective Thoracolumbar spine trauma (TST) is frequently associated with spinal cord injury and other soft tissue and bony injuries. The management of such injuries requires an evidence-based approach. This study used the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to assess the methodological quality of clinical guidelines for the management of TST published by the Congress of Neurological Surgeons (CNS). Methods All clinical guidelines on TST published by CNS until 2020 were assessed. Five appraisers from three international centers evaluated the quality of eligible clinical guidelines by using AGREE II. Mean AGREE II scores for each domain were determined. In higher-quality domains, the scores for individual items were analyzed. Results A total of 12 guidelines published by CNS on TST were assessed. Mean scores for all six domains were as follows: Scope and Purpose (75.2%), Stakeholder Involvement (45.4%), Rigor of Development (57.0%), Clarity of Presentation (58.7%), Applicability (16.9%), and Editorial Independence (64.1%). The mean score for the overall quality of all CNS guidelines was 52.9% [95% confidence interval (CI): 52.2-53.5%]. The overall agreement among appraisers was excellent [intra-class correlation coefficients (ICCs) for each guideline ranged from 0.903 to 0.963]. Conclusions CNS guidelines for the management of TST demonstrated acceptable quality across most domains; however, the domains of Applicability and Stakeholder Involvement could be further improved in future guideline updates. The assessors concluded that all guidelines could still be recommended for clinical practice with or without modifications.

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