The AO Spine Thoracolumbar Injury Classification System and Treatment Algorithm in Decision Making for Thoracolumbar Burst Fractures Without Neurologic Deficit.

Authors

• Barry T S Kweh
• Jin Wee Tee
• Charlotte Dandurand
• Alexander R Vaccaro
• Benneker M Lorin
• Klaus Schnake
• Emiliano Vialle
• Shanmuganathan Rajasekaran
• Mohammad El-Skarkawi
• Richard J Bransford
• Rishi M Kanna
• Mohamed M Aly
• Martin Holas
• Jose A Canseco
• Sander Muijs
• Eugen C Popescu
• Gaston Camino-Willhuber
• Andrei F Joaquim
• Harvinder S Chhabra
• Sebastian Frederick Bigdon
• Ulrich Spiegel
• Marcel Dvorak
• Cumhur F Öner
• Gregory Schroeder

Publication/Presentation Date

2-1-2024

Abstract

STUDY DESIGN: Prospective Observational Study.

OBJECTIVE: To determine the alignment of the AO Spine Thoracolumbar Injury Classification system and treatment algorithm with contemporary surgical decision making.

METHODS: 183 cases of thoracolumbar burst fractures were reviewed by 22 AO Spine Knowledge Forum Trauma experts. These experienced clinicians classified the fracture morphology, integrity of the posterior ligamentous complex and degree of comminution. Management recommendations were collected.

RESULTS: There was a statistically significant stepwise increase in rates of operative management with escalating category of injury (

CONCLUSIONS: The AO Spine Thoracolumbar Injury Classification system introduces fracture morphology in a rational and hierarchical manner of escalating severity. Thoracolumbar A4 complete burst fractures were more likely to be operatively managed than A3 fractures. Flexion-distraction type B injuries and translational type C injuries were much more likely to have surgery recommended than type A fractures regardless of the M1 modifier. A suspected posterior ligamentous injury increased the likelihood of surgeons favoring surgical stabilization.

Volume

14

Issue

1_suppl

First Page

32

Last Page

32

ISSN

2192-5682

Published In/Presented At

Kweh, B. T. S., Tee, J. W., Dandurand, C., Vaccaro, A. R., Lorin, B. M., Schnake, K., Vialle, E., Rajasekaran, S., El-Skarkawi, M., Bransford, R. J., Kanna, R. M., Aly, M. M., Holas, M., Canseco, J. A., Muijs, S., Popescu, E. C., Camino-Willhuber, G., Joaquim, A. F., Chhabra, H. S., Bigdon, S. F., … Schroeder, G. (2024). The AO Spine Thoracolumbar Injury Classification System and Treatment Algorithm in Decision Making for Thoracolumbar Burst Fractures Without Neurologic Deficit. Global spine journal, 14(1_suppl), 32S–40S. https://doi.org/10.1177/21925682231195764

Disciplines

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

PubMedID

38324601

Department(s)

Administration and Leadership

Document Type

Article