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

Abstract

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.

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

“…Also fluency in English was required to complete the surveys. The current survey was combined with two surveys of an AOSpine project that focuses on the development of a surgeon reported outcome instrument for spine trauma patients [20,21].…”

Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective

“…The tool was developed in an iterative fashion in several development cycles with sequential reviews and revisions in multiphase processes conducted in expert meetings. First, on the basis of two preparatory studies [8,9], a number of parameters were selected in this process and then refined further. In the developmental process of the AOSpine CROST, multiple versions of the tool including those parameters were pilot tested among several examples of spine trauma cases from the daily clinical practice.…”

“…'Wound healing' in surgically treated patient might impact patient care, e.g., in form of revision surgeries or ongoing antibiotic treatment. 'Functional recovery' was added to the clinician's perspectivebased AOSpine CROST tool while not having been evaluated in preparatory studies [8,9]. We felt that this parameter would add a valuable contribution to the overall tool, and provide a direct connection to the patient's reported outcome as expressed by AOSpine PROST (Patient Reported Outcome Spine Trauma).…”

“…In the developmental process of the tool, two separate surveys were conducted among international spine trauma experts in order to identify relevant clinical and radiological parameters for the thoracic and lumbar spine [8], and for the cervical spine [9]. Subsequently, integrating evidence from the preparatory studies with expert opinion, a working draft version of the AOSpine CROST was developed.…”

Development of the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST): a universal disease-specific outcome instrument for individuals with traumatic spinal column injury

“…However, the overall concept of the outcome instrument relates more to the functional impairment and the problems in daily living related to this impairment and not to specific treatment strategies such as the use of medication. Opioid use could be taken into account for the AOSpine CROST, the future outcome instrument from the perspective of the treating surgeons [22,23]. The findings obtained from the pilot study are of great value for refining the AOSpine PROST prior to multicenter validation of this instrument.…”