Accuracy and reliability of the AO Spine subaxial cervical spine classification system grading subaxial cervical facet injury morphology.

Autor: Cabrera JP; Department of Neurosurgery, Hospital Clínico Regional de Concepción, San Martín 1436, Concepción, Chile. jucabrera@udec.cl.; Faculty of Medicine, University of Concepción, Concepción, Chile. jucabrera@udec.cl., Yurac R; Department of Orthopedic and Traumatology, Department of Traumatology, University del Desarrollo (UDD). Spine Unit, Clínica Alemana, Santiago, Chile., Guiroy A; Spine Unit, Orthopedic Department, Hospital Español de Mendoza, Mendoza, Argentina., Joaquim AF; Department of Neurosurgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Carazzo CA; Department of Neurosurgery, University of Passo Fundo, São Vicente de Paulo Hospital, Passo Fundo, Rio Grande do Sul, Brazil., Zamorano JJ; Department of Orthopedic and Traumatology, Department of Traumatology, University del Desarrollo (UDD). Spine Unit, Clínica Alemana, Santiago, Chile., White KP; ScienceRight Research Consulting, London, ON, Canada., Valacco M; Department of Orthopedic and Traumatology, Hospital Churruca Visca, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2021 Jun; Vol. 30 (6), pp. 1607-1614. Date of Electronic Publication: 2021 Apr 11.
DOI: 10.1007/s00586-021-06837-w
Abstrakt: Purpose: A classification system was recently developed by the international association AO Spine for assessing subaxial cervical spine fractures. Significant variability exists between users of the facet component, which consists of four morphological types (F1-F4). The primary aims of this study were to assess the diagnostic accuracy and reliability of this new system's facet injury morphological classifications.
Methods: A survey consisting of 16 computed tomography (CT) scans of patients with cervical facet fractures was distributed to spine surgeon members of AO Spine Latin America. To provide a gold standard diagnosis for comparison, all 16 injuries had been classified previously by six co-authors and only were included after total consensus was achieved. Demographic and surgical practice characteristics of all respondents were analyzed, and diagnostic accuracy calculated. Inter- and intra-observer agreement rates were calculated across two survey rounds, conducted one month apart.
Results: A total of 135 surgeons completed both surveys, among whom the mean age was 41.6 years (range 26-71), 130 (96.3%) were men, and 83 (61.5%) were orthopedic surgeons. The mean time in practice as a spine surgeon was 9.7 years (1-30). The overall diagnostic accuracy of all responses was 65.4%. Inter-observer and intra-observer agreement rates for F1/F2/F3/F4 were 55.4%/47.6%/64.0%/94.7% and 60.0%/49.1%/58.0%/93.0%, respectively.
Conclusion: This study evaluates the AO Spine Classification System specifically for facet injuries involving the subaxial cervical spine in a large sample of spine surgeons. There was significant variability in diagnostic accuracy for F1 through F3-type fractures, whereas almost universal agreement was achieved for F4-type injuries.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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