Open AccessEvaluation of two novel thoracolumbar trauma classification systems
Author(s) -
Alpesh A. Patel,
Peter G. Whang,
Darrel S. Brodke,
Amit Agarwal,
Joseph Hong,
Carmella Fernandez,
Alexander R. Vaccaro
Publication year - 2007
Publication title -
indian journal of orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.434
H-Index - 33
eISSN - 1998-3727
pISSN - 0019-5413
DOI - 10.4103/0019-5413.36995
Subject(s) - medicine , kappa , cohen's kappa , orthopedic surgery , reliability (semiconductor) , radiography , physical therapy , injury severity score , neurosurgery , surgery , poison control , injury prevention , emergency medicine , statistics , philosophy , linguistics , power (physics) , mathematics , physics , quantum mechanics
Despite numerous attempts at classifying thoracolumbar spinal injuries, there remains no consensus on a single unifying algorithm of management. The ideal system should provide diagnostic and prognostic information, exhibit adequate reliability and validity and be easily applicable to clinical practice. The purpose of this study is to assess the reliability and validity of two novel classification systems for thoracolumbar fractures - the Thoracolumbar Injury Severity Score (TLISS) and the Thoracolumbar Injury Classification and Severity Score (TLICS) - and also to discuss potential efforts towards research in the future. MATEREIALS AND METHODS: Seventy-one patients with thoracolumbar fractures were prospectively assessed by surgeons with different levels of training and experience (attending orthopedic surgeon, attending neurosurgeon, spine fellows, senior level and junior level residents) at a single institution. Plain radiographs, CT and MRI imaging were used to classify these injuries using the TLISS system. Seven months later, 25 consecutive injuries were prospectively assessed with the TLISS and TLICS systems. Unweighted Cohen's kappa coefficients and Spearman's correlation values were calculated to assess inter-observer reliability and validity at each point in time.