Interobserver Reliability in the Classification of Thoracolumbar Fractures Using the AO Spine TL Injury Classification System Among 22 Clinical Experts in Spine Trauma Care.

Canseco, Jose A; Paziuk, Taylor; Schroeder, Gregory D; Dvorak, Marcel F; Öner, Cumhur F; Benneker, Lorin M; Vialle, Emiliano; Rajasekaran, Shanmuganathan; El-Sharkawi, Mohammad; Bransford, Richard J; Kanna, Rishi M; Holas, Martin; Muijs, Sander; Popescu, Eugen Cezar; Dandurand, Charlotte; Tee, Jin W; Camino-Willhuber, Gaston; Aly, Mohamed M; Joaquim, Andrei Fernandes; Keynan, Ory; ... (2024). Interobserver Reliability in the Classification of Thoracolumbar Fractures Using the AO Spine TL Injury Classification System Among 22 Clinical Experts in Spine Trauma Care. Global spine journal, 14(1_suppl), 17S-24S. Sage 10.1177/21925682231202371

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STUDY DESIGN

Reliability study utilizing 183 injury CT scans by 22 spine trauma experts with assessment of radiographic features, classification of injuries and treatment recommendations.

OBJECTIVES

To assess the reliability of the AOSpine TL Injury Classification System (TLICS) including the categories within the classification and the M1 modifier.

METHODS

Kappa and Intraclass correlation coefficients were produced. Associations of various imaging characteristics (comminution, PLC status) and treatment recommendations were analyzed through regression analysis. Multivariable logistic regression modeling was used for making predictive algorithms.

RESULTS

Reliability of the AO Spine TLICS at differentiating A3 and A4 injuries (N = 71) (K = .466; 95% CI .458 - .474; P < .001) demonstrated moderate agreement. Similarly, the average intraclass correlation coefficient (ICC) amongst A3 and A4 injuries was excellent (ICC = .934; 95% CI .919 - .947; P < .001) and the ICC between individual measures was moderate (ICC = .403; 95% CI .351 - .461; P < .001). The overall agreement on the utilization of the M1 modifier amongst A3 and A4 injuries was fair (K = .161; 95% CI .151 - .171; P < .001). The ICC for PLC status in A3 and A4 injuries averaged across all measures was excellent (ICC = .936; 95% CI .922 - .949; P < .001). The M1 modifier suggests respondents are nearly 40% more confident that the PLC is injured amongst all injuries. The M1 modifier was employed at a higher frequency as injuries were classified higher in the classification system.

CONCLUSIONS

The reliability of surgeons differentiating between A3 and A4 injuries in the AOSpine TLICS is substantial and the utilization of the M1 modifier occurs more frequently with higher grades in the system.

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:

Bigdon, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2192-5682

Publisher:

Sage

Language:

English

Submitter:

Pubmed Import

Date Deposited:

12 Feb 2024 16:14

Last Modified:

13 Feb 2024 15:08

Publisher DOI:

10.1177/21925682231202371

PubMed ID:

38324600

Uncontrolled Keywords:

AO spine thoracolumbar injury classification reliability thoracolumbar fractures

BORIS DOI:

10.48350/192667

URI:

https://boris.unibe.ch/id/eprint/192667

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