The reliability of the AOSpine Thoracolumbar Spine Injury Classification System in children: an international validation study.

Autor: Mo AZ; Department of Orthopaedic Surgery, Georgetown University Medical Center, Washington, District of Columbia, United States., Miller PE; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, United States., Pizones J; Spine Unit, Hospital Universitario La Paz, Madrid, Spain., Helenius I; Professor and Chairman, Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Ruf M; Center for Spinal Surgery, Orthopedics, and Traumatology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany., El-Hawary R; IWK Health Centre, Halifax, Nova Scotia, Canada., de Oliveira RG; Sarah Hospital, Brasília, Brazil., Ovadia D; Dana Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel., Kawakami N; Director of Spine & Scoliosis Center, Department of Orthopedic Surgery, Ichinomiyanishi Hospital, Ichinomiya, Japan., Crawford H; Paediatric Orthopaedic Surgeon, Starship Children's Hospital, Auckland, New Zealand., Odent T; Service de Chirurgie Orthopédique Pédiatrique, Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Hôpital Gatien-de-Clocheville, Tours, France., Yazici M; Hacettepe University, Faculty of Medicine, Orthopaedics, Ankara, Turkey., Johnson MB; Royal Children's Hospital, Melbourne, Victoria, Australia., Miyanji F; Department of Orthopedics, British Columbia Children's Hospital, Pediatric Orthopedics and Spine Surgery, Vancouver, British Columbia, Canada., Hedequist DJ; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, United States.
Jazyk: angličtina
Zdroj: Journal of children's orthopaedics [J Child Orthop] 2021 Oct 01; Vol. 15 (5), pp. 472-478.
DOI: 10.1302/1863-2548.15.200188
Abstrakt: Purpose: To evaluate the AOSpine Thoracolumbar Spine Injury Classification System and if it is reliable and reproducible when applied to the paediatric population globally.
Methods: A total of 12 paediatric orthopaedic surgeons were asked to review MRI and CT imaging of 25 paediatric patients with thoracolumbar spine traumatic injuries, in order to determine the classification of the lesions observed. The evaluators classified injuries into primary categories: A, B and C. Interobserver reliability was assessed for the initial reading by Fleiss's kappa coefficient (k F ) along with 95% confidence intervals (CI). For A and B type injuries, sub-classification was conducted including A0-A4 and B1-B2 subtypes. Interobserver reliability across subclasses was assessed using Krippendorff's alpha (α k ) along with bootstrapped 95% CIs. A second round of classification was performed one-month later. Intraobserver reproducibility was assessed for the primary classifications using Fleiss's kappa and sub-classification reproducibility was assessed by Krippendorff's alpha (α k ) along with 95% CIs.
Results: In total, 25 cases were read for a total of 300 initial and 300 repeated evaluations. Adjusted interobserver reliability was almost perfect (kF = 0.74; 95% CI 0.71 to 0.78) across all observers. Sub-classification reliability was substantial (α k = 0.67; 95% CI 0.51 to 0.81), Adjusted intraobserver reproducibility was almost perfect (kF = 0.91; 95% CI 0.83 to 0.99) for both primary classifications and for sub-classifications (α k = 0.88; 95% CI 0.83 to 0.93).
Conclusion: The inter- and intraobserver reliability for the AOSpine Thoracolumbar Spine Injury Classification System was high amongst paediatric orthopaedic surgeons. The AOSpine Thoracolumbar Spine Injury Classification System is a promising option as a uniform fracture classification in children.
Level of Evidence: III.
(Copyright © 2021, The author(s).)
Databáze: MEDLINE
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