Evidence map›Paper›PMID 25953527›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016

The surgical algorithm for the AOSpine thoracolumbar spine injury classification system.

Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler, F Cumhur Oner, Luiz R Vialle, Frank Kandziora, John D Koerner, Mark F Kurd, Max Reinhold, Klaus J Schnake and 4 more

2 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in 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, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 83 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05003180 naactive not recruitingnot on this mapstarted 2021, after this paper: background citation

SunBurst (StUdy oN Burst Fractures) - a National, Multicenter, Register-based, Randomized Controlled Trial on Thoracolumbar Burst Fractures

TypeinterventionalSponsorUppsala UniversityRan2021 to 2036Enrolled202ConditionsThoracolumbar Burst FractureArmsSurgical stabilization
NCT07471568 active not recruitingnot on this map

Comparative Outcomes of Orthopedic Bracing, Percutaneous Vertebroplasty, and Spinal Arthrodesis for Traumatic AO Type A1 Vertebral Fractures: A Retrospective Clinical Study

TypeobservationalSponsorUniversity of ValenciaRan2007 to 2027Enrolled146ConditionsTraumatic Vertebral Fractures, Compression Fractures of the Spine, AO Type A1 Vertebral Fracture, Spinal Trauma
3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Guideline
  2. How reliable is the distinction between thoracolumbar AO type A3 and A4 fractures? A systematic literature review.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 · 2024
    Pooled it
  3. How does vertical laminar fracture impact the decision-making in thoracolumbar fractures? A systematic scoping review and meta-analysis.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 · 2024
    Pooled it
  4. Current treatment and outcomes of traumatic sternovertebral fractures: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021
    Pooled it
  5. Trial
  6. Does usage of a parachute in contrast to free fall prevent major trauma?: a prospective randomised-controlled trial in rag dolls.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 · 2016
    Trial
  7. Preoperative hounsfield unit measurements predict non-infectious complications following posterior spinal instrumentation for traumatic thoracolumbar fractures.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 · 2026
    Article
  8. Complication rates in thoracolumbar fracture-dislocations with and without neurological injury.Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2026
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Thoracolumbar injuries: prehospital and emergency management, imaging, classifications and clinical implications.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Review
  17. Traumatic thoracic spine fracture: can we predict when MRI would modify the fracture classification or decision-making compared to CT alone?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 · 2024
    Article
  18. ESTES recommendation on thoracolumbar spine fractures : January 2023.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
    Review
  19. A Novel Bipedicular Dissociation Fracture Pattern of Vertebral Osteoporotic Fractures of the Elderly.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024
    Article
  20. Article

23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Alexander R VaccaroThe Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA. alexvaccaro3@aol.com.
Gregory D SchroederThe Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA.
Christopher K KeplerThe Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA.
F Cumhur OnerUniversity Medical Center, Utrecht, The Netherlands.
Luiz R VialleCatholic University, Curitiba, Brazil.
Frank KandzioraBerufsgenossenschaftliche Unfallklinik Frankfurt, Center for Spinal Surgery and Neurotraumatology, Frankfurt/Main, Germany.
John D KoernerThe Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA.
Mark F KurdThe Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA.
Max ReinholdKlinikum Suedstadt Rostock, Department of Orthopaedic and Trauma Surgery, Suedring 81, 18059, Rostock, Germany.
Klaus J SchnakeSchön Klinik Nürnberg Fürth, Center for Spinal Therapy, Fürth, Germany.
Jens ChapmanThe Swedish Neuroscience Institute, Seattle, WA, USA.
Bizhan AarabiUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Michael G FehlingsUniversity of Toronto, Toronto, ON, Canada.
Marcel F DvorakUniversity of British Columbia, Vancouver, BC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe goal of the current study is to establish a surgical algorithm to accompany the AOSpine thoracolumbar spine injury classification system.

methodsA survey was sent to AOSpine members from the six AO regions of the world, and surgeons were asked if a patient should undergo an initial trial of conservative management or if surgical management was warranted. The survey consisted of controversial injury patterns. Using the results of the survey, a surgical algorithm was developed.

resultsThe AOSpine Trauma Knowledge forum defined that the injuries in which less than 30% of surgeons would recommend surgical intervention should undergo a trial of non-operative care, and injuries in which 70% of surgeons would recommend surgery should undergo surgical intervention. Using these thresholds, it was determined that injuries with a thoracolumbar AOSpine injury score (TL AOSIS) of three or less should undergo a trial of conservative treatment, and injuries with a TL AOSIS of more than five should undergo surgical intervention. Operative or non-operative treatment is acceptable for injuries with a TL AOSIS of four or five.

conclusionThe current algorithm uses a meaningful injury classification and worldwide surgeon input to determine the initial treatment recommendation for thoracolumbar injuries. This allows for a globally accepted surgical algorithm for the treatment of thoracolumbar trauma.

Indexed as

AlgorithmsDecision MakingDelphi TechniqueGlobal HealthHealth Care SurveysHumansInjury Severity ScoreLumbar VertebraeProfessional PracticeSpinal FracturesSpinal InjuriesThoracic VertebraeAOSpine thoracolumbar spine injury classification systemSpine traumaThoracolumbar traumaThoracolumbar trauma treatment algorithmTL AOSIS

Identifiers

PMID25953527

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.