Alexander R Vaccaro1, John D Koerner2, Kris E Radcliff2, F Cumhur Oner3, Maximilian Reinhold4, Klaus J Schnake5, Frank Kandziora6, Michael G Fehlings7, Marcel F Dvorak8, Bizhan Aarabi9, Shanmuganathan Rajasekaran10, Gregory D Schroeder2, Christopher K Kepler2, Luiz R Vialle11. 1. Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA. alexvaccaro3@aol.com. 2. Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA. 3. University Medical Center, Utrecht, The Netherlands. 4. Department of Orthopaedic and Trauma Surgery, Klinikum Suedstadt Rostock, Suedring 81, 18059, Rostock, Germany. 5. Schön Klinik Nürnberg Fürth, Center for Spinal Surgery, Fürth, Germany. 6. Berufsgenossenschaftliche Unfallklinik Frankfurt, Center for Spinal Surgery and Neurotraumatology, Frankfurt, Germany. 7. University of Toronto Spine Program and Toronto Western Hospital, Toronto, ON, Canada. 8. University of British Columbia, Vancouver, BC, Canada. 9. University of Maryland Medical Center, College Park, MD, USA. 10. Ganga Hospital, Coimbatore, Tamil Nadu, India. 11. Catholic University of Parana, Curitiba, Brazil.
Abstract
PURPOSE: This project describes a morphology-based subaxial cervical spine traumatic injury classification system. Using the same approach as the thoracolumbar system, the goal was to develop a comprehensive yet simple classification system with high intra- and interobserver reliability to be used for clinical and research purposes. METHODS: A subaxial cervical spine injury classification system was developed using a consensus process among clinical experts. All investigators were required to successfully grade 10 cases to demonstrate comprehension of the system before grading 30 additional cases on two occasions, 1 month apart. Kappa coefficients (κ) were calculated for intraobserver and interobserver reliability. RESULTS: The classification system is based on three injury morphology types similar to the TL system: compression injuries (A), tension band injuries (B), and translational injuries (C), with additional descriptions for facet injuries, as well as patient-specific modifiers and neurologic status. Intraobserver and interobserver reliability was substantial for all injury subtypes (κ = 0.75 and 0.64, respectively). CONCLUSIONS: The AOSpine subaxial cervical spine injury classification system demonstrated substantial reliability in this initial assessment, and could be a valuable tool for communication, patient care and for research purposes.
PURPOSE: This project describes a morphology-based subaxial cervical spine traumatic injury classification system. Using the same approach as the thoracolumbar system, the goal was to develop a comprehensive yet simple classification system with high intra- and interobserver reliability to be used for clinical and research purposes. METHODS: A subaxial cervical spine injury classification system was developed using a consensus process among clinical experts. All investigators were required to successfully grade 10 cases to demonstrate comprehension of the system before grading 30 additional cases on two occasions, 1 month apart. Kappa coefficients (κ) were calculated for intraobserver and interobserver reliability. RESULTS: The classification system is based on three injury morphology types similar to the TL system: compression injuries (A), tension band injuries (B), and translational injuries (C), with additional descriptions for facet injuries, as well as patient-specific modifiers and neurologic status. Intraobserver and interobserver reliability was substantial for all injury subtypes (κ = 0.75 and 0.64, respectively). CONCLUSIONS: The AOSpine subaxial cervical spine injury classification system demonstrated substantial reliability in this initial assessment, and could be a valuable tool for communication, patient care and for research purposes.
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