Reliability and application of the new morphological classification system for chronic symptomatic osteoporotic thoracolumbar fracture View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-08-24

AUTHORS

Ding-Jun Hao, Jun-Song Yang, Yuan Tuo, Chao-Yuan Ge, Bao-Rong He, Tuan-Jiang Liu, Da-Geng Huang, Shuai-jun Jia, Peng Liu, Jia-Nan Zhang, Jin-Peng Du

ABSTRACT

BackgroundWe propose a new classification system for chronic symptomatic osteoporotic thoracolumbar fracture (CSOTF) based on fracture morphology. Research on CSOTF has increased in recent years; however, the lack of a standard classification system has resulted in inconvenient communication, research, and treatment. Previous CSOTF classification studies exhibit different symptoms, with none being widely accepted.MethodsImaging data of 368 patients with CSOTF treated at our hospital from January 2010 to June 2017 were systematically analyzed to develop a classification system. Imaging examinations included dynamic radiography, computed tomography scans, and magnetic resonance imaging. Ten investigators methodically studied the classification system grading in 40 cases on two occasions, examined 1 month apart. Kappa coefficients (κ) were calculated to determine intraobserver and interobserver reliability. Based on the radiographic characteristics, the patients were divided into 5 types, and different treatments were suggested for each type. Clinical outcome evaluation included using the visual analog score (VAS), the Oswestry disability index (ODI), and the American Spinal Injury Association (ASIA) impairment scale.ResultsThe new classification system for CSOTF was divided into types I–V according to whether the CSOTF exhibited dynamic instability, spinal stenosis or kyphosis deformity. Intra- and interobserver reliability were excellent for all types (κ = 0.83 and 0.85, respectively). The VAS score and ODI of each type were significantly improved at the final follow-up compared with those before surgery. In all patients with neurological impairment, the ASIA grading after surgery was significantly improved compared with that before surgery (P < 0.001).ConclusionsThe new classification system for CSOTF demonstrated excellent reliability in this initial assessment. The treatment algorithm based on the classification can result in satisfactory improvement of clinical efficacy for the patients of CSOFT. More... »

PAGES

348

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13018-020-01882-5

DOI

http://dx.doi.org/10.1186/s13018-020-01882-5

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https://app.dimensions.ai/details/publication/pub.1130295543

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32831125


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25 schema:description BackgroundWe propose a new classification system for chronic symptomatic osteoporotic thoracolumbar fracture (CSOTF) based on fracture morphology. Research on CSOTF has increased in recent years; however, the lack of a standard classification system has resulted in inconvenient communication, research, and treatment. Previous CSOTF classification studies exhibit different symptoms, with none being widely accepted.MethodsImaging data of 368 patients with CSOTF treated at our hospital from January 2010 to June 2017 were systematically analyzed to develop a classification system. Imaging examinations included dynamic radiography, computed tomography scans, and magnetic resonance imaging. Ten investigators methodically studied the classification system grading in 40 cases on two occasions, examined 1 month apart. Kappa coefficients (κ) were calculated to determine intraobserver and interobserver reliability. Based on the radiographic characteristics, the patients were divided into 5 types, and different treatments were suggested for each type. Clinical outcome evaluation included using the visual analog score (VAS), the Oswestry disability index (ODI), and the American Spinal Injury Association (ASIA) impairment scale.ResultsThe new classification system for CSOTF was divided into types I–V according to whether the CSOTF exhibited dynamic instability, spinal stenosis or kyphosis deformity. Intra- and interobserver reliability were excellent for all types (κ = 0.83 and 0.85, respectively). The VAS score and ODI of each type were significantly improved at the final follow-up compared with those before surgery. In all patients with neurological impairment, the ASIA grading after surgery was significantly improved compared with that before surgery (P < 0.001).ConclusionsThe new classification system for CSOTF demonstrated excellent reliability in this initial assessment. The treatment algorithm based on the classification can result in satisfactory improvement of clinical efficacy for the patients of CSOFT.
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32 schema:keywords ASIA grading
33 American Spinal Injury Association Impairment Scale
34 BackgroundWe
35 Disability Index
36 Impairment Scale
37 Oswestry Disability Index
38 VAS scores
39 algorithm
40 analogue score
41 applications
42 assessment
43 cases
44 characteristics
45 classification
46 classification studies
47 classification system
48 clinical efficacy
49 clinical outcome evaluation
50 coefficient
51 communication
52 data
53 deformity
54 different symptoms
55 different treatments
56 dynamic instability
57 dynamic radiography
58 efficacy
59 evaluation
60 examination
61 excellent reliability
62 fracture morphology
63 fractures
64 grading
65 hospital
66 imaging
67 imaging examinations
68 impairment
69 improvement
70 inconvenient communication
71 index
72 initial assessment
73 instability
74 interobserver reliability
75 intra
76 investigators
77 kappa coefficient
78 kyphosis deformity
79 lack
80 magnetic resonance imaging
81 months
82 morphological classification system
83 morphology
84 neurological impairment
85 new classification system
86 occasions
87 osteoporotic thoracolumbar fractures
88 outcome evaluation
89 patients
90 radiographic characteristics
91 radiography
92 recent years
93 reliability
94 research
95 resonance imaging
96 satisfactory improvement
97 scale
98 scans
99 scores
100 spinal stenosis
101 standard classification system
102 stenosis
103 study
104 surgery
105 symptoms
106 system
107 thoracolumbar fractures
108 tomography scan
109 treatment
110 treatment algorithm
111 type I
112 types
113 visual analogue score
114 years
115 schema:name Reliability and application of the new morphological classification system for chronic symptomatic osteoporotic thoracolumbar fracture
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