TY  - JOUR
PY  - 2021//
TI  - The reliability of the AOSpine Thoracolumbar Spine Injury Classification System in children: an international validation study
JO  - Journal of children's orthopaedics
A1  - Mo, Andrew Z.
A1  - Miller, Patricia E.
A1  - Pizones, Javier
A1  - Helenius, Ilkka
A1  - Ruf, Michael
A1  - El-Hawary, Ron
A1  - de Oliveira, Rafael Garcia
A1  - Ovadia, Dror
A1  - Kawakami, Noriaki
A1  - Crawford, Haemish
A1  - Odent, Thierry
A1  - Yazici, Muharrem
A1  - Johnson, Michael B.
A1  - Miyanji, Firoz
A1  - Hedequist, Daniel J.
SP  - 472
EP  - 478
VL  - 15
IS  - 5
N2  - PURPOSE: To evaluate the AOSpine Thoracolumbar Spine Injury Classification System and if it is reliable and reproducible when applied to the paediatric population globally. <br><br>METHODS: A total of 12 paediatric orthopaedic surgeons were asked to review MRI and CT imaging of 25 paediatric patients with thoracolumbar spine traumatic injuries, in order to determine the classification of the lesions observed. The evaluators classified injuries into primary categories: A, B and C. Interobserver reliability was assessed for the initial reading by Fleiss's kappa coefficient (k(F)) along with 95% confidence intervals (CI). For A and B type injuries, sub-classification was conducted including A0-A4 and B1-B2 subtypes. Interobserver reliability across subclasses was assessed using Krippendorff's alpha (α(k)) along with bootstrapped 95% CIs. A second round of classification was performed one-month later. Intraobserver reproducibility was assessed for the primary classifications using Fleiss's kappa and sub-classification reproducibility was assessed by Krippendorff's alpha (α(k)) along with 95% CIs. <br><br>RESULTS: In total, 25 cases were read for a total of 300 initial and 300 repeated evaluations. Adjusted interobserver reliability was almost perfect (kF = 0.74; 95% CI 0.71 to 0.78) across all observers. Sub-classification reliability was substantial (α(k)= 0.67; 95% CI 0.51 to 0.81), Adjusted intraobserver reproducibility was almost perfect (kF = 0.91; 95% CI 0.83 to 0.99) for both primary classifications and for sub-classifications (α(k) = 0.88; 95% CI 0.83 to 0.93). <br><br>CONCLUSION: The inter- and intraobserver reliability for the AOSpine Thoracolumbar Spine Injury Classification System was high amongst paediatric orthopaedic surgeons. The AOSpine Thoracolumbar Spine Injury Classification System is a promising option as a uniform fracture classification in children. LEVEL OF EVIDENCE: III.<p />  <p>Language: en</p>
LA  - en
SN  - 1863-2521
UR  - http://dx.doi.org/10.1302/1863-2548.15.200188
ID  - ref1
ER  -