Posterior Ligament–Bone Injury Classification and Severity Score
Autor: | Baorong He, Zhao Qinpeng, Jun-Song Yang, Zhengping Zhang, Liang Yan, Haiping Zhang, Yuan Tuo, Dingjun Hao, Peng Liu, Yuan-Ting Zhao, Tuanjiang Liu, Dageng Huang |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Facet (geometry) Intraclass correlation Joint Dislocations Severity of Illness Index Zygapophyseal Joint Random Allocation Young Adult 03 medical and health sciences Injury Severity Score Postoperative Complications 0302 clinical medicine Predictive Value of Tests Severity of illness medicine Humans Orthopedics and Sports Medicine Treatment Failure 030222 orthopedics Ligaments Cervical fracture business.industry Reproducibility of Results Middle Aged medicine.disease Surgery medicine.anatomical_structure Predictive value of tests Cervical Vertebrae Ligament Spinal Fractures Female Neurology (clinical) business Complication 030217 neurology & neurosurgery Follow-Up Studies |
Zdroj: | Spine. 46:209-215 |
ISSN: | 1528-1159 0362-2436 |
Popis: | Study design Clinical case series. Objective The aim of this study was to propose a novel posterior ligament-bone injury classification and severity (PLICS) score system that can be used to reflect the severity of subaxial cervical fracture dislocations (SCFDs) and predict the failure of anterior-only surgery; and to measure the intraobserver and interobserver reliability of this system. Summary of background data The approach selection for SCFDs is controversial. Although the anterior approach is familiar for most surgeons, postoperative hardware failure and/or delayed cervical deformity is a nonnegligible complication. Methods Ten patients were randomly selected for intraobserver reliability evaluation on two separate occasions, one month apart. Another 30 patients were randomly selected, and the interobserver reliability was measured by comparing results of each case between each reviewer and averaging. To analyze the difference in the PLICS score, 354 patients fulfilled the follow-up were divided into stable and unstable groups according to whether radiologically stable was observed during follow-up. Results For the intraobserver reliability, the mean intraclass correlation coefficient for the 10 reviewers was 0.931. For the interobserver reliability, the mean interobserver correlation coefficient for the three elements was 0.863. Among 16 patients with PLICS score ≥7, two patients in the stable group manifested with severe injury of the posterior ligamentous complex (PLC); extremely unstable lateral mass fractures with or without severe injury of PLC were detected in the 14 patients of the unstable group. Conclusion The proposed PLICS score system showed excellent intraobserver and interobserver reliability. When a PLICS score is >7 or 7 accompanied by extremely unstable lateral mass fractures, the risk of postoperative failure after an anterior-only reconstruction is high and supplemental posterior strengthening can be considered.Level of Evidence: 4. |
Databáze: | OpenAIRE |
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