Differences between neurosurgeons and orthopedic surgeons in classifying cervical dislocation injuries and making assessment and treatment decisions: a multicenter reliability study.

Authors

• Paul M Arnold
• Darrel S Brodke
• Y Raja Rampersaud
• James S Harrop
• Andrew T Dailey
• Christopher I Shaffrey
• Jonathan N Grauer
• Marcel F S Dvorak
• Christopher M Bono
• Jared T Wilsey
• Joon Y Lee
• Ahmad Nassr
• Alexander R Vaccaro

Publication/Presentation Date

10-1-2009

Abstract

Variability exists in the management of cervical spinal injuries. The goal of this study was to assess the effect of training specialty (orthopedic surgery vs neurosurgery) on management of cervical dislocations. Twenty-nine spine surgeons reviewed 10 cases of cervical dislocation injuries. For each of the 10 cases, the surgeons evaluated 3 clinical scenarios, which included a neurologically intact patient, a patient with an incomplete spinal cord injury (SCI), and a patient with complete SCI. Surgeons determined whether a unilateral or bilateral facet dislocation was present and whether pretreatment magnetic resonance imaging (MRI) or immediate closed reduction was indicated. Management decisions were re-assessed after review of MRIs. While spine surgeons may agree on what they see on MRI and how they classify certain cervical injuries irrespective of training, significant differences of opinion continue to exist regarding the therapeutic implications of this information, specifically, whether to order a pretreatment MRI and how to manage the injury.

Volume

38

Issue

10

First Page

156

Last Page

161

ISSN

1934-3418

Published In/Presented At

Arnold, P. M., Brodke, D. S., Rampersaud, Y. R., Harrop, J. S., Dailey, A. T., Shaffrey, C. I., Grauer, J. N., Dvorak, M. F., Bono, C. M., Wilsey, J. T., Lee, J. Y., Nassr, A., Vaccaro, A. R., & Spine Trauma Study Group (2009). Differences between neurosurgeons and orthopedic surgeons in classifying cervical dislocation injuries and making assessment and treatment decisions: a multicenter reliability study. American journal of orthopedics (Belle Mead, N.J.), 38(10), E156–E161.

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

20011745

Department(s)

Administration and Leadership

Document Type

Article