scholarly journals Assessment of the Accuracy of the AO Spine-TL Classification for Thoracolumbar Spine Fractures Using the AO Surgery Reference Mobile App

2020 ◽  
pp. 219256822090169
Author(s):  
Allan Hiroshi de Araujo Ono ◽  
Verônica Yulin Prieto Chang ◽  
Erico Myung Rodenbeck ◽  
Alex Oliveira de Araujo ◽  
Rafael Garcia de Oliveira ◽  
...  
Keyword(s):  
Thoracolumbar Spine ◽  
Fracture Morphology ◽  
Neurological Status ◽  
Mobile App ◽  
Spine Fractures ◽  
Thoracolumbar Fractures ◽  
Kappa Index ◽  
Thoracolumbar Spine Fractures ◽  
Fractures Of The Spine ◽  
Classification Agreement

Study Design: Cohort study. Objectives: This study aimed to evaluate the accuracy of the AO Surgery Reference mobile app in the diagnosis of thoracolumbar fractures of the spine according to the AO TL classification, and to discuss the usefulness of this app in the teaching and training of the resident physicians in orthopedics and traumatology area. Methods: The 24 residents of Orthopedic and Traumatology program assessed 20 cases of thoracolumbar fractures selected from the hospital database on 2 different occasions, with a 30-day interval, and they classified these cases with and without using the AO Surgery Reference app. A group of spine experts previously established the gold standard and the answers were statistically compared, with the inter- and intraobserver reliability evaluated by the kappa index. Results: The use of the AO Surgery Reference app increased the classification success rate of the fracture morphology (from 53.4% to 72.5%), of the comorbidity modifier (from 61.4% to 77.9%) and of the neurological status modifier (from 55.1% to 72.9%). In addition, the mobile app raised the classification agreement and accuracy. The kappa index increased from 0.30 to 0.53 regarding the morphological classification of fractures. Conclusions: The residents improved their ability to recognize and classify thoracolumbar spine fractures, which reinforces the importance of this tool in medical education and clinical practice.

scholarly journals Timing of surgery in thoracolumbar trauma: is early intervention safe?

2014 ◽  
Vol 37 (1) ◽  
pp. E7 ◽  
Author(s):  
Christopher Paul O'Boynick ◽  
Mark F. Kurd ◽  
Bruce V. Darden ◽  
Alexander R. Vaccaro ◽  
Michael G. Fehlings
Keyword(s):  
Spinal Cord ◽  
Posterior Instrumentation ◽  
Thoracolumbar Spine ◽  
Spine Fractures ◽  
Thoracolumbar Fractures ◽  
Surgical Timing ◽  
Cord Injury ◽  
Thoracolumbar Spine Fractures ◽  
Support Cost ◽  
Early Fixation

The understanding of the optimal surgical timing for stabilization in thoracolumbar fractures is severely limited. Thoracolumbar spine fractures can be devastating injuries and are often associated with significant morbidity and mortality. The role of early surgical stabilization (within 48–72 hours of injury) as a vehicle to improve outcomes in these patients has generated significant interest. Goals of early stabilization include improved neurological recovery, faster pulmonary recovery, improved pain control, and decreased health care costs. Opponents cite the potential for increased bleeding, hypotension, and the risk of further cord injury as a few factors that weigh against early stabilization. The concept of spinal cord injury and its relationship to surgical timing remains in question. However, when neurological outcomes are eliminated from the equation, certain measures have shown positive influences from prompt surgical fixation. Early fixation of thoracolumbar spine fractures can significantly decrease the duration of hospital stay and the number of days in the intensive care unit. Additionally, prompt stabilization can reduce rates of pulmonary complications. This includes decreased rates of pneumonia and fewer days on ventilator support. Cost analysis revealed as much as $80,000 in savings per patient with early stabilization. All of these benefits come without an increase in morbidity or evidence of increased mortality. In addition, there is no evidence that early stabilization has any ill effect on the injured or uninjured spinal cord. Based on the existing data, early fixation of thoracolumbar fractures has been linked with positive outcomes without clear evidence of negative impacts on the patient's neurological status, associated morbidities, or mortality. These procedures can be viewed as “damage control” and may consist of simple posterior instrumentation or open reductions with internal fixation as indicated. Based on the current literature it is advisable to proceed with early surgical stabilization of thoracolumbar fractures in a well-resuscitated patient, unless extenuating medical conditions would prevent it.

scholarly journals Treatment Options for Thoracolumbar Spine Fractures

2005 ◽  
Vol 5 (2) ◽  
pp. 20-26 ◽  
Author(s):  
Eldin E. Karaiković ◽  
Hector O. Pacheco
Keyword(s):  
Nonoperative Management ◽  
Treatment Options ◽  
Thoracolumbar Spine ◽  
Educational Background ◽  
Spine Fractures ◽  
Thoracolumbar Fractures ◽  
Short Segment ◽  
Risks And Benefits ◽  
Thoracolumbar Spine Fractures ◽  
Surgical Option

A decision for operative versus nonoperative management of thoracolumbar fractures should NEVER be based solely on one factor. Only after a thorough physical, neurological, and spinal examination, and an assessment of a patient’s prior activity, social and educational background and patient’s expectations, one should review the patient’s radiographs and CT scans to determine risks and benefits of operative versus nonoperative care. Both treatment options are discussed in this paper. As a surgical option our preference is short-segment instrumentation and fusion. Careful and appropriate patient selection and an excellent operative technique insure the minimum complications.

Residual spinal segment fixation in burst thoracolumbar spine fractures

TRAUMA ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 82-87
Author(s):  
K.A. Popsuyshapka ◽  
M.Yu. Karpinskiy ◽  
S.A. Teslenko ◽  
E.D. Karpinska ◽  
A.I. Popov
Keyword(s):  
Thoracolumbar Spine ◽  
Spine Fractures ◽  
Spinal Segment ◽  
Thoracolumbar Spine Fractures

Predictors of Recovery After Conservative Treatment of AO-Type A Thoracolumbar Spine Fractures Without Neurological Deficit

Spine ◽  
2018 ◽  
Vol 43 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Peter Vorlat ◽  
Geert Leirs ◽  
Farhad Tajdar ◽  
Heinz Hulsmans ◽  
Hugo De Boeck ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Neurological Deficit ◽  
Thoracolumbar Spine ◽  
Type A ◽  
Spine Fractures ◽  
Thoracolumbar Spine Fractures

Is a Pelvic Fracture a Predictor for Thoracolumbar Spine Fractures After Blunt Trauma?

2009 ◽  
Vol 67 (5) ◽  
pp. 1027-1032 ◽  
Author(s):  
Martin H. Pouw ◽  
Jaap Deunk ◽  
Monique Brink ◽  
Helena M. Dekker ◽  
Digna R. Kool ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Pelvic Fracture ◽  
Thoracolumbar Spine ◽  
Spine Fractures ◽  
Thoracolumbar Spine Fractures

Reliability of smartphone-based teleradiology for evaluating thoracolumbar spine fractures

2017 ◽  
Vol 17 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Ido Stahl ◽  
Daniel Dreyfuss ◽  
Dror Ofir ◽  
Lior Merom ◽  
Michael Raichel ◽  
...  
Keyword(s):  
Thoracolumbar Spine ◽  
Spine Fractures ◽  
Thoracolumbar Spine Fractures

scholarly journals Does Tranexamic Acid Reduce Perioperative Bleeding in Short Segment Pedicle Screw Fixation in Thoracolumbar Spine Fractures?

2015 ◽  
Vol 53 (199) ◽  
pp. 169-173 ◽  
Author(s):  
Rabindra Lal Pradhan ◽  
Bimal Kumar Pandey
Keyword(s):  
Tranexamic Acid ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Thoracolumbar Spine ◽  
Pedicle Screw Fixation ◽  
Control Group ◽  
Thoracolumbar Fractures ◽  
Short Segment ◽  
Perioperative Bleeding ◽  
Thoracolumbar Spine Fractures

Introduction: Blood loss with spinal surgery is common potential cause of morbidity and often requires blood transfusion. Tranexamic acid (TXA), is effective in reducing bleeding in patients undergoing knee arthroplasty. TXA used in spine surgery studies have included different cases leading to inconsistence of surgical procedures. Purpose of this prospective observational study was to examine effect of TXA decreasing bleeding in short segment pedicle screw fixation for thoracolumbar fractures. Methods: 38 patients' undergoing short segment pedicle screw for thoracolumbar fractures were enrolled in study from July to August 2013. There were 28 male and 10 female patients, with an average age of 36.5 years. Patients received 10 mg/kg of TXA or a control 30 minutes intravenously before skin incision and 3 hours post-operative and oral medication for three days. Intraoperative bleeding was estimated by weighing surgical sponges, blood collected by suction container and by subtracting all irrigation fluid. Postoperative bleeding was measured from volume in vacuum drainage bag. Results: Twenty (20) patients were in control group and eighteen(18) to TXA group. There were no statistical differences between groups in terms of age, gender, co-morbidities, and operating time, preoperative Hemoglobin, PT and INR. Intra-operative bleeding in TXA group was significant than in control group. Post-operative drainage and Hemoglobin in first 48 h was reduced compared with placebo in TXA group. Need for post-operative transfusion was nil in TXA group. Conclusions: Administration of TXA before surgery significantly reduces perioperative bleeding in patients undergoing short segment pedicle screw fixation for thoracolumbar spine fractures.  Keywords: bleeding; spinal surgery; tranexamic acid.

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