Intraobserver and interobserver reproducibility of the old and new classifications of toracolombar fractures

Lopes, Felipe Augusto Rozales; Ferreira, Ana Paula Bonilauri; Santos, Ricardo André Acácio dos; Maçaneiro, Carlos Henrique

doi:10.1016/j.rboe.2018.07.015

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…Spine surgeons are yet to universally agree on the use of a single classification system. Many studies support AO TLICS as the most complete and reliable classification system for thoracolumbar injuries [25][26][27][28][29][30]. Yet, a recent systematic review by Hwang et al [5] concludes that the inter-observer reliability for Type B-particularly subtype B3-varies vastly and that poor reliability was demonstrated for the A4 subtype.…”

Section: Discussionmentioning

confidence: 99%

Thoracolumbar spine trauma: a guide for the FRCS examination

Hwang

Abdalla

Ajayi

et al. 2022

Eur J Orthop Surg Traumatol

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Thoracolumbar spine injuries are commonly seen in trauma settings and have a high risk of causing serious morbidity. There can be controversy when it comes to classifying thoracolumbar injuries within the spinal community, but there remains a need to classify, evaluate and manage thoracolumbar fractures. This article aims to provide a guide on classification of thoracolumbar spine injuries using the AO Spine Thoracolumbar Injury Classification System (AO TLICS).

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Section: Discussionmentioning

confidence: 99%

Thoracolumbar spine trauma: a guide for the FRCS examination

Hwang

Abdalla

Ajayi

et al. 2022

Eur J Orthop Surg Traumatol

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Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

et al. 2021

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To formulate the specific guidelines for the recommendation of thoracolumbar fracture regarding surgical techniques and nonfusion surgery. WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meeting. For nonfusion surgery and thoracolumbar fracture, a systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020. The search was further refined by excluding the articles which were duplicate, not in English or were based on animal or cadaveric subjects. After thorough shortlisting, only 50 articles were selected for full review in this consensus meeting. To generate a consensus, the levels of agreement or disagreement on each item were voted independently in a blind fashion through a Likert-type scale from 1 to 5. The consensus was achieved when the sum for disagreement or agreement was ≥ 66%. Each consensus point was clearly defined with evidence strength, recommendation grade, and consensus level provided. A magnitude of prospective papers were analyzed to formulate consensus on various surgical techniques that can be employed to address different types of thoracolumbar fractures. Surgical treatment of thoracolumbar fractures can be a better option over the nonoperative approach, especially for those who cannot tolerate months in an orthosis or cast, such as those with multiple extremity injuries, skin lesions, obesity, and so forth. It generally allows early mobilization, less hospital stay, reduced pulmonary complications, and better correction of sagittal balance. Current available literature fails to demonstrate any statistically significant benefit of fusion surgery over nonfusion in thoracolumbar fractures.

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Analysis of the Classification Systems for Thoracolumbar Fractures in Adults and Their Evolution and Impact on Clinical Management

Costăchescu

Popescu

Iliescu

2022

JCM

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Although they represent a significant chapter of traumatic pathology with a deep medical and social impact, thoracolumbar fractures have proven to be elusive in terms of a definitive classification. The ever-changing concept of the stability of a thoracolumbar injury (from Holdsworth’s two-column concept to Denis’ three-column theory), the meaningful integration of neurological deficit, and a reliable clinical usability have made reaching a universally accepted and reproductible classification almost impossible. The advent of sophisticated imaging techniques and an improved understanding of spine biomechanics led to the development of several classification systems. Each successive system has contributed significantly to the understanding of physiopathological mechanisms and better treatment management. Magerl et al. developed a comprehensive classification system based on progressive morphological damage determined by the following three fundamental forces: compression, distraction, and axial torque. Vaccaro et al. devised the thoracolumbar injury severity score based on the following three independent variables: the morphology of the injury, posterior ligamentous complex (PLC) integrity, and neurological status at the time of injury. However, there are limitations to the classification system, especially when magnetic resonance imaging yields an uncertain status of PLC. The authors review the various classification systems insisting on their practical relevance and caveats and illustrate the advantages and disadvantages of the most widely used systems with relevant cases from their practice.

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Intraobserver and interobserver reproducibility of the old and new classifications of toracolombar fractures

Cited by 4 publications

References 15 publications

Thoracolumbar spine trauma: a guide for the FRCS examination

Thoracolumbar spine trauma: a guide for the FRCS examination

Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Analysis of the Classification Systems for Thoracolumbar Fractures in Adults and Their Evolution and Impact on Clinical Management

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