ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017
Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study.
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, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Acute management of spinal fractures: What you need to know.The journal of trauma and acute care surgery · 2026Review
- Spine Trauma Classifications: Historical, Current, and Emerging Perspectives for Radiologists.The Indian journal of radiology & imaging · 2025Review
- Reliability of thoracolumbar burst fracture classification in the Swedish Fracture Register.BMC musculoskeletal disorders · 2024Article
- Significant Reduction in Bone Density as Measured by Hounsfield Units in Patients with Ankylosing Spondylitis or Diffuse Idiopathic Skeletal Hyperostosis.Journal of clinical medicine · 2024Article
- The AO Spine Thoracolumbar Injury Classification System and Treatment Algorithm in Decision Making for Thoracolumbar Burst Fractures Without Neurologic Deficit.Global spine journal · 2024Article
- Percutaneous reduction of thoracolumbar fractures using monoaxial screws: Comparison of two instruments based on initial reduction and loss of reduction.Brain & spine · 2024Article
- Thoracolumbar spine trauma: a guide for the FRCS examination.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Automated detection and classification of acute vertebral body fractures using a convolutional neural network on computed tomography.Frontiers in endocrinology · 2023Article
- Analysis of the Classification Systems for Thoracolumbar Fractures in Adults and Their Evolution and Impact on Clinical Management.Journal of clinical medicine · 2022Review
- Interobserver reliability of the Gehweiler classification and treatment strategies of isolated atlas fractures: an internet-based multicenter survey among spine surgeons.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Reliability and repeatability of a modified thoracolumbar spine injury classification scoring system.Frontiers in surgery · 2022Article
- Superiority of thoracolumbar injury classification and severity score (TLICS) over AOSpine thoracolumbar spine injury classification for the surgical management decision of traumatic spine injury in the pediatric population.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 · 2021Article
- A modified MRI protocol for the increased detection of sacrococcygeal fractures in patients with thoracolumbar junction fractures.Scientific reports · 2021Article
- The Effect of Thoracolumbar Injury Classification in the Clinical Outcome of Operative and Non-Operative Treatments.Cureus · 2021Review
- [Risk factors of recurrent kyphosis in thoracolumbar burst fracture patients treated by short segmental pedicle screw fixation].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2020Article
- Reliability and Clinical Usefulness of Current Classifications in Traumatic Thoracolumbar Fractures: A Systematic Review of the Literature.International journal of spine surgery · 2020Article
- Article
- Early Spinal Injury Stabilization in Multiple-Injured Patients: Do All Patients Benefit?Journal of clinical medicine · 2020Article
- Classifications in Brief: AO Thoracolumbar Classification System.Clinical orthopaedics and related research · 2020Review
- A simplified treatment algorithm for treating thoracic and lumbar spine trauma.The journal of spinal cord medicine · 2019Review
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12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries.
methodsClinical and radiological data of 50 consecutive patients admitted at a single centre with a diagnosis of an acute traumatic thoracolumbar spine injury were distributed to eleven attending spine surgeons from six different institutions in the form of PowerPoint presentation, who classified them according to both classifications. After time span of 6 weeks, cases were randomly rearranged and sent again to same surgeons for re-classification. Interobserver and intraobserver reliability for each component of TLICS and new AOSpine classification were evaluated using Fleiss Kappa coefficient (k value) and Spearman rank order correlation.
resultsModerate interrater and intrarater reliability was seen for grading fracture type and integrity of posterior ligamentous complex (Fracture type: k = 0.43 ± 0.01 and 0.59 ± 0.16, respectively, PLC: k = 0.47 ± 0.01 and 0.55 ± 0.15, respectively), and fair to moderate reliability (k = 0.29 ± 0.01 interobserver and 0.44+/0.10 intraobserver, respectively) for total score according to TLICS. Moderate interrater (k = 0.59 ± 0.01) and substantial intrarater reliability (k = 0.68 ± 0.13) was seen for grading fracture type regardless of subtype according to AOSpine classification. Near perfect interrater and intrarater agreement was seen concerning neurological status for both the classification systems.
conclusionsRecently proposed AOSpine classification has better reliability for identifying fracture morphology than the existing TLICS. Additional studies are clearly necessary concerning the application of these classification systems across multiple physicians at different level of training and trauma centers to evaluate not only their reliability and reproducibility, but also the other attributes, especially the clinical significance of a good classification system.
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