Development of Online Technique for International Validation of the AO Spine Subaxial Injury Classification System.

Lambrechts, Mark J; Schroeder, Gregory D; Karamian, Brian A; Canseco, Jose A; Oner, Cumhur; Vialle, Emiliano; Rajasekaran, Shanmuganathan; Hazenbiller, Olesja; Dvorak, Marcel R; Benneker, Lorin M; Kandziora, Frank; Schnake, Klaus; Kepler, Christopher K; Vaccaro, Alexander R (2024). Development of Online Technique for International Validation of the AO Spine Subaxial Injury Classification System. Global Spine Journal, 14(1), pp. 177-186. Thieme 10.1177/21925682221098967

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STUDY DESIGN

Global cross-sectional survey.

OBJECTIVE

To develop and refine the techniques for web-based international validation of fracture classification systems.

METHODS

A live webinar was organized in 2018 for validation of the AO Spine Subaxial Injury Classification System, consisting of 35 unique computed tomography (CT) scans and key images with subaxial spine injuries. Interobserver reliability and intraobserver reproducibility was calculated for injury morphology, subtype, and facet injury according to the classification system. Based on the experiences from this webinar and incorporating rater feedback, adjustments were made in the organization and techniques used and in 2020 a repeat validation webinar was performed, evaluating images of 41 unique subaxial spine injuries.

RESULTS

In the 2018 session, the AO Spine Subaxial Injury Classification System demonstrated fair interobserver reliability for fracture subtype (κ = 0.35) and moderate reliability for fracture morphology and facet injury (κ=0.45, 0.43, respectively). However, in 2020, the interobserver reliability for fracture morphology (κ = 0.87) and fracture subtype (κ = 0.80) was excellent, while facet injury was substantial (κ = 0.74). Intraobserver reproducibility for injury morphology (κ =0.49) and injury subtype/facet injury were moderate (κ = 0.42) in 2018. In 2020, fracture morphology and subtype reproducibility were excellent (κ =0.85, 0.88, respectively) while reproducibility for facet injuries was substantial (κ = 0.76).

CONCLUSION

With optimized webinar-based validation techniques, the AO Spine Subaxial Injury Classification System demonstrated vast improvements in intraobserver reproducibility and interobserver reliability. Stringent fracture classification methodology is integral in obtaining accurate classification results.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Benneker, Lorin Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2192-5682

Publisher:

Thieme

Language:

English

Submitter:

Pubmed Import

Date Deposited:

28 Apr 2022 09:57

Last Modified:

25 Nov 2023 00:11

Publisher DOI:

10.1177/21925682221098967

PubMed ID:

35475400

Uncontrolled Keywords:

CT cervical spine injury classification methodology vertebral body fracture

BORIS DOI:

10.48350/169580

URI:

https://boris.unibe.ch/id/eprint/169580

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