Researchers Develop Thoracolumbar AOSpine Injury Score
Gregory D. Schroeder, MD Comments
Researchers have developed a data-driven, easy to use Thoracolumbar AOSpine Injury Score (TL AOSIS) that will be used to develop a surgical algorithm to accompany the AOSpine Thoracolumbar Injury Classification System (TLICS), according to a paper in a recent issue of Global Spine Journal.
“This study allows for the conversion of the important aspects of a complex thoracolumbar injury (injury morphology, neurologic status of the patient, and patient specific modifiers) into an easy to use injury score,” said coauthor Gregory D. Schroeder, MD, Spine Surgery Fellow at the Rothman Institute at Thomas Jefferson University in Philadelphia, PA. “The TL AOSIS can then be used for determining the ideal treatment algorithm, as well as an important research tool.”
“The impetus for this study was to develop a surgical algorithm to accompany the AOSpine Thoracolumbar Injury Classification System,” Dr. Schroeder explained. “Currently, there is no universally accepted thoracolumbar injury classification, with surgeons from North America often using Thoracolumbar Injury Classification System (TLICS), and surgeons from other parts of the often world preferring the Magerl/AO system. The new AOSpine Thoracolumbar Injury Classification System attempts to incorporate the best aspects of both of the aforementioned classifications, and with the help of the Thoracolumbar AOSpine Injury Score (TL AOSIS), a straightforward surgical algorithm has been developed.”
A group of 100 international spine surgeons were invited to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System including injury morphology, neurologic injury, and patient-specific modifiers. Grades ranged from 0 (not severe at all) to 100 (most severe injury possible). Responses were received from 75 of the surgeons.
The survey results were used to place the classification system components into a hierarchy based on relative injury severity. “The hierarchy of neurologic and other modifiers was consistently rated and scored by surgeons and confirms the increasing severity of injury expressed within this classification system,” the researchers wrote.
“The TL AOSIS is a straightforward and easy to use injury score,” Dr. Schroeder concluded. “Modeled after the TLICS injury severity score, the TL AOSIS will allow surgeons of all regions of the world and experience levels to apply an algorithmic approach to thoracolumbar trauma.”