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Eur Spine J. 2016 Apr;25(4):1087-94. doi: 10.1007/s00586-015-3982-2. Epub 2015 May 8.

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

Author information

1
The Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA. alexvaccaro3@aol.com.
2
The Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, 5th floor, Philadelphia, PA, 19107, USA.
3
University Medical Center, Utrecht, The Netherlands.
4
Catholic University, Curitiba, Brazil.
5
Berufsgenossenschaftliche Unfallklinik Frankfurt, Center for Spinal Surgery and Neurotraumatology, Frankfurt/Main, Germany.
6
Klinikum Suedstadt Rostock, Department of Orthopaedic and Trauma Surgery, Suedring 81, 18059, Rostock, Germany.
7
Schön Klinik Nürnberg Fürth, Center for Spinal Therapy, Fürth, Germany.
8
The Swedish Neuroscience Institute, Seattle, WA, USA.
9
University of Maryland School of Medicine, Baltimore, MD, USA.
10
University of Toronto, Toronto, ON, Canada.
11
University of British Columbia, Vancouver, BC, Canada.

Abstract

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.

KEYWORDS:

AOSpine thoracolumbar spine injury classification system; Spine trauma; TL AOSIS; Thoracolumbar trauma; Thoracolumbar trauma treatment algorithm

PMID:
25953527
DOI:
10.1007/s00586-015-3982-2
[Indexed for MEDLINE]

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