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. 2016 Jun;6(4):329-34.
doi: 10.1055/s-0035-1563610. Epub 2015 Sep 29.

The Thoracolumbar AOSpine Injury Score

Christopher K Kepler  1 , Alexander R Vaccaro  1 , Gregory D Schroeder  1 , John D Koerner  1 , Luiz R Vialle  2 , Bizhan Aarabi  3 , Shanmuganathan Rajasekaran  4 , Carlo Bellabarba  5 , Jens R Chapman  6 , Frank Kandziora  7 , Klaus J Schnake  8 , Marcel F Dvorak  9 , Max Reinhold  10 , F Cumhur Oner  11
Affiliations

The Thoracolumbar AOSpine Injury Score

Christopher K Kepler et al. Global Spine J. 2016 Jun.

Abstract

Study Design Survey of 100 worldwide spine surgeons. Objective To develop a spine injury score for the AOSpine Thoracolumbar Spine Injury Classification System. Methods Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System. Using the results, as well as limited input from the AOSpine Trauma Knowledge Forum, the Thoracolumbar AOSpine Injury Score was developed. Results Beginning with 1 point for A1, groups A, B, and C were consecutively awarded an additional point (A1, 1 point; A2, 2 points; A3, 3 points); however, because of a significant increase in the severity between A3 and A4 and because the severity of A4 and B1 was similar, both A4 and B1 were awarded 5 points. An uneven stepwise increase in severity moving from N0 to N4, with a substantial increase in severity between N2 (nerve root injury with radicular symptoms) and N3 (incomplete spinal cord injury) injuries, was identified. Hence, each grade of neurologic injury was progressively given an additional point starting with 0 points for N0, and the substantial difference in severity between N2 and N3 injuries was recognized by elevating N3 to 4 points. Finally, 1 point was awarded to the M1 modifier (indeterminate posterolateral ligamentous complex injury). Conclusion The Thoracolumbar AOSpine Injury Score is an easy-to-use, data-driven metric that will allow for the development of a surgical algorithm to accompany the AOSpine Thoracolumbar Spine Injury Classification System.

Keywords: AOSpine; AOSpine injury score; TL AOSIS; thoracolumbar spine injury classification system; thoracolumbar trauma.

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Conflict of interest statement

Disclosures Christopher K. Kepler, Personal fees: AOSpine, Healthgrades, Inc. Alexander R. Vaccaro, Personal fees: AOSpine, Medtronic, Stryker, Globus, Gerson Lehrman Group, Guidepoint Global, Medacorp, Innovative Surgical Design, Orthobullets, Expert testimony, Ellipse, Spinicity, Spine Medica, Computational Biodynamics, Progressive Spinal Technologies, Spinology, Small Bone Innovations, Cross Current, In Vivo, Flagship Surgical, Advanced Spinal Intellectual Properties, Cytonics, Bonovo Orthopaedics, Electrocore, Gamma Spine, Location Based Intelligence, FlowPharma, R.S.I., Replication Medica, Stout Medical, Rothman Institute and Related Properties; Grant: Cerapedics; Royalties: Thieme, Jaypee, Elsevier, Taylor and Francis, Aesculap, Globus, Medtronic, Stryker, DePuy Gregory D. Schroeder, Grant: Medtronic John D. Koerner, Personal fees: AOSpine, Medtronic Luiz R. Vialle, Personal fees: AOSpine; Board member: AO Foundation Bizhan Aarabi, Personal fees: AOSpine Shanmuganathan Rajasekaran, Personal fees: AOSpine Carlo Bellabarba, Personal fees: AOSpine; Grant: AOSpine, AOSpine North America, Depuy, Omega Jens R. Chapman, Personal fees: AOSpine, Renovis Medical; Royalties: Thieme Frank Kandziora, Personal fees: AOSpine, ESJ-OOT; Board member: Eurospine, DWG, DGOU, AOSpine; Consultant: Depuy, Siemens; Speakers' bureau: Depuy, Siemens, AOSpine Klaus J. Schnake, Personal fees: AOSpine, Medtronic, Expanding Orthopaedics, OttoBock Healthcare, Depuy; Grant: AOSpine Marcel F. Dvorak, Personal fees: AOSpine Max Reinhold, Personal fees: AOSpine F. Cumhur Oner, Personal fees: AOSpine, Medtronic, Synthes; Grant: AOSpine, Depuy

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