The Diagnostic Process of Spinal Post-traumatic Deformity: An Expert Survey of 7 Cases, Consensus on Clinical Relevance Does Exist.

Autor:	De Gendt EEA; Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands., Benneker LM; Orthopedic Department, Sonnenhofspital, Bern, Switzerland., Joaquim AF; Department of Neurosurgery, State University of Campinas, Campinas, Brazil., El-Sharkawi M; Department of Orthopaedic and Trauma Surgery, Assiut University Medical School, Assiut, Egypt., Dhakal GR; National Trauma Center, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal., Kandziora F; Center for Spinal Surgery and Neurotraumatology, BG Unfallklinik Frankfurt am Main gGmbH, Frankfurt, Germany., Tee J; Departement of Neurosurgery, The Alfred Hospital, Melbourne, Australia., Bransford RJ; Department of Orthopaedics, University of Washington, Seattle, WA., Vialle EN; Department of Orthopaedics, Cajuru Hospital, Catholic University of Paraná, Curitiba, Brazil., Vaccaro AR; Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA., Popescu EC; 'Prof. Dr. N. Oblu' Emergency Hospital, Iasi, Romania., Kanna RM; Department of Orthopaedic and Spine Surgery, Ganga Hospital, Coimbatore, India., Polly DW; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN., Schnake KJ; Center for Spinal and Scoliosis Therapy, Malteser Waldkrankenhaus St. Marien, Erlangen., Berjano P; IRRCS Istituto Ortopedico Galeazzi, Milano., Ryabykh S; National Ilizarov Medical Research Center for Traumatology and Ortopaedics, Russia., Neva M; Theater and Spine Surgery, Tampere University Hospital, Finland Unit, Tampere, Finland., Lamartina C; IRRCS Istituto Ortopedico Galeazzi, Milano., Rothenfluh DA; Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, England., Lewis SJ; Toronto Western Hospital, University Health Network, Toronto, ON, Canada., Muijs SPJ; Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands., Oner FC; Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Clinical spine surgery [Clin Spine Surg] 2023 Oct 01; Vol. 36 (8), pp. E383-E389. Date of Electronic Publication: 2023 Jun 26.
DOI:	10.1097/BSD.0000000000001478
Abstrakt:	Study Design: Survey of cases. Objective: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD). Summary of Background Data: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved. Methods: The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated. Results: Seventeen spinal surgeons reviewed the presented cases. The items' fracture type and complaints were rated by the participants as more important, but no agreement existed on the items of medical history. In patients with possible SPTD in the cervical spine (C) area, participants requested a conventional radiograph (CR) (76%-83%), a flexion/extension CR (61%-71%), a computed tomography (CT)-scan (76%-89%), and a magnetic resonance (MR)-scan (89%-94%). In thoracolumbar spine (ThL) cases, full spine CR (89%-100%), CT scan (72%-94%), and MR scan (65%-94%) were requested most often. There was a consensus on 5 out of 7 cases with clinically relevant SPTD (82%-100%). When consensus existed on the diagnosis of SPTD, there was a consensus on the case being compensated or decompensated and being symptomatic or asymptomatic. Conclusions: There was strong agreement in 5 out of 7 cases on the presence of the diagnosis of clinically relevant SPTD. Among spine experts, there is a strong consensus to use CT scan and MR scan, a cervical CR for C-cases, and a full spine CR for ThL-cases. The lack of agreement on items of the medical history suggests that a Delphi study can help us reach a consensus on the essential items of clinically relevant SPTD. Level of Evidence: Level V. Competing Interests: The authors declare no conflict of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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