Purpose The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon's geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. Conclusion More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.

Purpose To validate the AO Spine Subaxial Injury Classification System with participants of various experience levels, subspecialties, and geographic regions. Methods A live webinar was organized in 2020 for validation of the AO Spine Subaxial Injury Classification System. The validation consisted of 41 unique subaxial cervical spine injuries with associated computed tomography scans and key images. Intraobserver reproducibility and interobserver reliability of the AO Spine Subaxial Injury Classification System were calculated for injury morphology, injury subtype, and facet injury. The reliability and reproducibility of the classification system were categorized as slight (ƙ = 0–0.20), fair (ƙ = 0.21–0.40), moderate (ƙ = 0.41–0.60), substantial (ƙ = 0.61–0.80), or excellent (ƙ = > 0.80) as determined by the Landis and Koch classification. Results A total of 203 AO Spine members participated in the AO Spine Subaxial Injury Classification System validation. The percent of participants accurately classifying each injury was over 90% for fracture morphology and fracture subtype on both assessments. The interobserver reliability for fracture morphology was excellent (ƙ = 0.87), while fracture subtype (ƙ = 0.80) and facet injury were substantial (ƙ = 0.74). The intraobserver reproducibility for fracture morphology and subtype were excellent (ƙ = 0.85, 0.88, respectively), while reproducibility for facet injuries was substantial (ƙ = 0.76). Conclusion The AO Spine Subaxial Injury Classification System demonstrated excellent interobserver reliability and intraobserver reproducibility for fracture morphology, substantial reliability and reproducibility for facet injuries, and excellent reproducibility with substantial reliability for injury subtype.

OBJECTIVE The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5–10 years, 10–20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery). METHODS A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson’s chi-square or Fisher’s exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility. RESULTS The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5–10 years: 0.69 vs 10–20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5–10 years: 0.62 vs 10–20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5–10 years: 0.61 vs 10–20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36). CONCLUSIONS The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system.

Re ci bi do el 18-7-2013. Acep ta do lue go de la eva lua ción el 19-11-2013. Co rres pon den cia:dr. FedeRico d. sARtoR fedes_3@yahoo.com Re su menIn tro duc ción: la escoliosis idiopática del adolescente es una afección de personas sanas. el objetivo del trabajo es evaluar el nivel de ocupación laboral de pacientes operados por escoliosis idiopática del adolescente sin complicaciones. Materiales y Métodos: estudio retrospectivo realizado en una sola institución. se evaluaron 50 pacientes. Variables: edad, sexo, residencia, escolaridad, dificultades escolares, ocupación, dificultades para conseguir empleo y asistencia social. Resultados: cuarenta y ocho pacientes eran mujeres (96%), el 68% tenía entre 20 y 25 años. el 52% vive en el conurbano bonaerense (26 pacientes); el 24%, en la ciudad Autónoma de Buenos Aires (12 pacientes) y el 24%, en el resto del país. el 40% no terminó sus estudios universitarios (20 pacientes); el 12%, sí (6 pacientes). el 12% completó estudios terciarios (6 pacientes), el 8% no (4 pacientes). el 22% no terminó la escuela secundaria (11 pacientes) y el 2%, sí (un paciente). el 4% no completó la escuela primaria (2 pacientes), el 54% trabaja en la actualidad y el 46% no lo hace. el 16% tuvo dificultades para conseguir empleo (8 pacientes) y el 84% respondió que no (42 pacientes). el 10% gestionó una pensión por discapacidad (5 pacientes), y todos la obtuvieron. Conclusión: Veintisiete trabajan actualmente y 23 no lo hacen (54% y 46%, respectivamente). el porcentaje de pacientes que solicitó pensión por discapacidad en cualquiera de sus formas es menor que el sospechado antes de realizar la investigación. no sugerimos solicitar asistencia social en pacientes operados de escoliosis idiopática del adolescente.Palabrasclave:Escoliosisidiopáticadeladolescente. Trabajo. Levelofoccupationinpatientssurgically treatedforadolescentidiopathicscoliosisAbstract Background: Adolescent idiopathic scoliosis is a condition that affects healthy people. the objective of this study is to evaluate the level of occupation of patients who underwent surgical treatment of adolescent idiopathic scoliosis. Methods:Retrospective study performed at one institution. Fifty patients were retrospectively evaluated. Variables: age, gender, residence, education, learning difficulties, occupation, difficulties to obtain a job and whether they have or not a welfare plan. Results: Forty-eight patients were women (96%), 68% were between 20 and 25 years old. 52% live at Gran Buenos Aires (26 patients), 24% live in ciudad Autónoma de Buenos Aires (12 patients) and 24% live in the rest of the country. Forty percent did not complete college studies (20 patients), 12% did (6 patients). twelve percent finished higher education (6 patients), 8% did not (4 patients). twenty-two percent did not complete high school education (11 patients), while 2% did (1 patient). Four percent of the patients did not finish primary school (2 patients). currently 54% is employed, while 46% do not have a job. sixteen patients experienced difficulties...

<p align="JUSTIFY"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><strong>Introducción:</strong> es práctica frecuente en nuestro centro realizar controles clínicos y radiológicos durante el primer año POP de EIA, habitualmente en el POP inmediato, 3, 6, 9 y 12 meses. Es conocido el impacto negativo de estas radiaciones sobre el cuerpo humano y no hay guías claras sobre cuál sería el esquema óptimo de seguimiento radiológico.</span></span></p><p align="JUSTIFY"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><strong>Materiales y métodos:</strong> se realizó un estudio retrospectivo de 55 pacientes operados por vía post. Con tornillos pediculares sin síntomas de rediculopatía ni pérdida de corrección clínica, analizándose los hallazgos radiológicos durante el primer año POP. Se evaluaron las intercurrencias que presentó este grupo y su impacto en la conducta terapéutica.</span></span></p><p align="JUSTIFY"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><strong>Resultado: </strong>edad media: 15,1; media del Risser: 3,7 (0-5); porcentaje de pedículos instrumentados en la curva: 81,7 %; media de corrección de la curva principal: 74%; la media de espinogramas POP de la población fue de 3,7 +/- 0.93 (cada espinograma consta de un frente y un perfil). Ningún Pte. Del grupo tuvo modificación de la conducta terapéutica en base a los hallazgos radiológicos.</span></span></p><p align="JUSTIFY"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><strong>Conclusión:</strong> en los pacientes con diagnóstico de EIA operados con tornillos pediculares que no presenten síntomas de radiculopatía, dolores persistentes y/o pérdida clínica de corrección se podrían reducir los controles radiológicos a 3 durante el primer año POP.</span></span></p><p align="JUSTIFY"><span style="font-family: 'Times New Roman', serif;"><span style="font-size: medium;"><strong>Palabras clave:</strong> escoliosis idiopatica del adolescente; control radiografico</span></span></p>