Reliability of the evaluation of posterior ligamentous complex injury in thoracolumbar spine trauma with the use of computed tomography scan

Barcelos, Alécio Cristino Evangelista Santos; Joaquim, Andrei Fernandes; Botelho, Ricardo Vieira

doi:10.1007/s00586-016-4377-8

Cited by 28 publications

(23 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The literature search identified 63 unique records, of which 17 were selected for the full-text review and 9 articles 3,20-27 were included in the final review (Figure 1). There was a substantial variation in the characteristics of included studies in terms of the number of observers and cases and imaging modalities (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Reliability and Validity of the AOSpine Thoracolumbar Injury Classification System: A Systematic Review

Abedi

Mokkink

Zadegan

et al. 2018

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Systematic review. Objectives: The AOSpine thoracolumbar injury classification system (ATLICS) is a relatively simple yet comprehensive classification of spine injuries introduced in 2013. This systematic review summarizes the evidence on measurement properties of this new classification, particularly the reliability and validity of the main morphologic injury types with and without inclusion of the subtypes. Methods: A literature search was performed using PubMed and Embase in September 2016. A revised version of the COSMIN checklist was used for evaluation of the quality of studies. Two independent reviewers performed all steps of the review. Results: Nine articles were included in the final review, all of which evaluated the reliability of the ATLICS and had a fair methodological quality. The reliability of the modifiers was unknown. Overall, the quality of evidence for reliability of the morphologic and neurologic classification sections was low. However, there was moderate evidence for poor interobserver reliability of the morphologic classification when all subtypes were included, and moderate evidence for good intraobserver reliability with exclusion of subtypes. The reliability of the morphologic classification was independent of the observer’s experience and cultural background. Conclusions: ATLICS represents the most current system for evaluation of thoracolumbar injuries. Based on this review, further studies with robust methodological quality are needed to evaluate the measurement properties of ATLICS. Shortcomings of the reliability studies are discussed.

show abstract

Section: Resultsmentioning

confidence: 99%

Reliability and Validity of the AOSpine Thoracolumbar Injury Classification System: A Systematic Review

Abedi

Mokkink

Zadegan

et al. 2018

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…Vaccaro et al claimed interspinous spacing greater than that of level above or below on anteroposterior plain X-rays can be higher rank criteria for diagnosis of PLC injury than focal tenderness and palpation of interspinous defect [20]. Barecelo et al claims that the increase of interspinous distance is the single most important criterion in confirming PLC injury on CT image [1]. This claim was based on inter-oberver reliability.…”

Section: Discussionmentioning

confidence: 97%

Another diagnostic tool in thoracolumbar posterior ligament complex injury: interspinous distance ratio

et al. 2016

View full text Add to dashboard Cite

In this study, in cases where it was difficult to make a diagnosis of the injury in the posterior ligament complex, based on the interspinous distance ratio (ISDR) of 120 % measured in plain X-ray in a lateral decubitus position, the sensitivity was 81.3 %, the specificity was 76.2 %, and the accuracy was 79.2 %. Therefore, measuring the ISDR will be helpful in determining whether surgical treatment is required in patients with thoracolumbar injury.

show abstract

“…Unstable burst fractures, with posterior ligament rupture characterized by dislocation of the facet joints, diastasis of the spinous process, and subluxations, should be considered as B2 injuries (flexion-distractive mechanism) with a burst component. 7,[15][16][17] Finally, another question that needs further investigation is if there is any difference in the outcome of incomplete (A3) versus complete (A4) burst fractures, which have been evaluated together in the spinal trauma literature until the advent of the AOSTSIC. As far as we know, there is no specific radiological characteristic of a burst fracture in a neurologically intact patient that may guide operative versus nonoperative management.…”

Section: Types A3-a4 (Incomplete and Complete Burst Fractures)mentioning

confidence: 99%

Operative versus Non-Operative Management of Traumatic Thoracolumbar Injuries according to the AO Spine Thoracolumbar Spine Injury Classification System

Joaquim

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

View full text Add to dashboard Cite

Introduction The AOSpine Thoracolumbar Spine Injury Classification (AOSTSIC) system has been proposed to better characterize injury morphologies and improve the classification of thoracolumbar (TL) spine trauma. However, the indications for surgical treatment according to the AOSTSIC system are still debated. Additionally, the proposed Thoracolumbar AOSpine Injury Score (AOSIS) is quite complex, which may preclude its use in daily practice. The objective of this review is to discuss the AOSTSIC system and its indications for initial nonoperative versus surgical management of acute TL spine trauma. Methods We analyzed the literature for each injury type (and subtype, when pertinent) according to the AOSTSIC system as well as their potential treatment options. Results Patients with AOSTSIC subtypes A0, A1, and A2 are neurologically intact in the vast majority of the cases and initially managed nonoperatively. The treatment of A3- and A4-subtype injuries (burst fractures) in neurologically-intact patients is still debated with great controversy, with initially nonoperative management being considered an option in select patients. Surgery is recommended when there are neurological deficits or failure of nonoperative management, with the role of magnetic resonance findings in the Posterior Ligamentous Complex (PLC) evaluation still being considered controversial. Injuries classified as type B1 in neurologically-intact patients may be treated, initially, with nonoperative management, provided that there are no ligamentous injury and non-displacing fragments. Due to severe ligamentous injury, type-B and type-C injuries should be considered as unstable injuries that must be surgically treated, regardless of the neurological status of the patient. Conclusions Until further evidence, we provided an easy algorithm-based guide on the spinal trauma literature to help surgeons in the decision-making process for the treatment of TL spine injuries classified according to the new AOSTSIC system.

show abstract

Reliability of the evaluation of posterior ligamentous complex injury in thoracolumbar spine trauma with the use of computed tomography scan

Abstract: In this study, the use of CT scan as the only diagnostic tool could identify PLC injury in most cases and demonstrated satisfactory reliability. Dislocation could satisfactorily diagnose type C injury, while IID was the best parameter to differentiate between type A and B injuries.

Cited by 28 publications

References 40 publications

Reliability and Validity of the AOSpine Thoracolumbar Injury Classification System: A Systematic Review

Reliability and Validity of the AOSpine Thoracolumbar Injury Classification System: A Systematic Review

Another diagnostic tool in thoracolumbar posterior ligament complex injury: interspinous distance ratio

Operative versus Non-Operative Management of Traumatic Thoracolumbar Injuries according to the AO Spine Thoracolumbar Spine Injury Classification System

Contact Info

Product

Resources

About