TY - JOUR
T1 - The surgical algorithm for the AOSpine thoracolumbar spine injury classification system
AU - Vaccaro, Alexander R.
AU - Schroeder, Gregory D.
AU - Kepler, Christopher K.
AU - Cumhur Oner, F.
AU - Vialle, Luiz R.
AU - Kandziora, Frank
AU - Koerner, John D.
AU - Kurd, Mark F.
AU - Reinhold, Max
AU - Schnake, Klaus J.
AU - Chapman, Jens
AU - Aarabi, Bizhan
AU - Fehlings, Michael G.
AU - Dvorak, Marcel F.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Purpose: The goal of the current study is to establish a surgical algorithm to accompany the AOSpine thoracolumbar spine injury classification system. Methods: A 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. Results: The 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. Conclusion: The 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.
AB - Purpose: The goal of the current study is to establish a surgical algorithm to accompany the AOSpine thoracolumbar spine injury classification system. Methods: A 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. Results: The 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. Conclusion: The 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.
KW - AOSpine thoracolumbar spine injury classification system
KW - Spine trauma
KW - Thoracolumbar trauma
KW - Thoracolumbar trauma treatment algorithm
KW - TL AOSIS
UR - https://www.scopus.com/pages/publications/84929069933
U2 - 10.1007/s00586-015-3982-2
DO - 10.1007/s00586-015-3982-2
M3 - Article
C2 - 25953527
AN - SCOPUS:84929069933
SN - 0940-6719
VL - 25
SP - 1087
EP - 1094
JO - European Spine Journal
JF - European Spine Journal
IS - 4
ER -