aospine tl-classification injury severity score · 2020. 3. 26. · aospine tl-classification...

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity Score

Welcome!

Dear Participant of the AOSpine TLClassification Validation study, Thank you once again for your valuable contribution to the AOSpine TLClassification Validation Study. As you are now experienced in applying the new classification system, we would like to additionally assess your perception of the Injury Severity Score of each fracture type, neurologic injury, and their modifiers. This survey aims to assess the perceived severity of different types of thoracolumbar fractures as described in the new AOSpine thoracolumbar classification system. Please evaluate each fracture type and score your perceived level of instability or severity relative to the other fracture types. A benign fracture would be scored closer to 0 and a very severe fracture requiring surgery would be scored closer to 100. The compiled data will illustrate any regional or cultural differences in perceived injury severity. Additionally, the results may help establish an international standard of treatment for thoracolumbar injuries based on the AOSpine TL trauma classification system and severity score. The survey consists of 13 questions and should take no longer than 5 minutes to complete. Many thanks in advance for your support and contribution! The AOSpine TLClassification Validation Study Team


Please answer the following questions before you start with the scoring of the fracture types.

AOSpine TLClassification Severity Score

How many years of practice do you have?*Years of practice: 6

How many spine trauma patients do you treat approximately per year?*Spine trauma patients per year: 6


Each of the following injuries will be scored on a scale of 0100 in terms of their perceived severity, 0 being benign and 100 being most severe. Neurovascular injuries or polytrauma status will not be considered. For more information on the fracture types, please download the new AOSpine TLClassification brochure which is available through the following link: https://aospine.aofoundation.org/Structure/research/knowledgeforum/Documents/AOSpineTLClassificationBrochure_2013.pdf

The Severity Score Morphology

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreA0 Spinous/Transverse Process Fracture Does not compromise the structural integrity of the spinal column


Please score this fracture type on a scale of 0100 in terms of their perceived severity (0=benign, 100=most severe)*Injury Severity Score

Type A0: 6

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity Score A1 Wedge/Compression Fracture Fracture of a single endplate without involvement of the posterior wall of the vertebral body


A2 Split/Pincer Fracture Fracture of both endplates without involvement of the posterior wall of the vertebral body


Type A1: 6



Type A2: 6

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity Score A3 Incomplete Burst Fracture Fracture of a single endplate with any involvement of the posterior wall. Vertical fracture of the lamina usually present


A4 Complete Burst Fracture Fracture with any involvement of the posterior wall and both endplates Vertical fracture of the lamina is usually present


Type A3: 6


B1 Transosseuous Tension Band Disruption/Chance Fracture Monosegmental pure osseous failure of the posterior tension band


Type A4: 6



Type B1: 6

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity Score B2 Posterior Tension Band Disruption Bony and/or ligamentary failure of the posterior tension band together with a Type A fracture


B3 Hyperextension Injury through the disk or vertebral body leading to a hyperextended spinal column Common in ankylotic disorders Anterior longitudinal ligament (ALL) commonly ruptured


Type B2: 6



Type B3: 6

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity Score C Displacement or Dislocation Dissociation between cranial and caudal segments allows for various configurations



Type C 6


Each of the following neurologic injuries and modifiers will be scored on a scale of 0100 in terms of their perceived severity, 0 being benign and 100 being most severe. For more information on the neurologic injuries and modifiers, please download the new AOSpine TLClassification brochure which is available through the following link: https://aospine.aofoundation.org/Structure/research/knowledgeforum/Documents/AOSpineTLClassificationBrochure_2013.pdf

The Severity Score Neurology and Modifiers

Please score the following neurologic injuries on a scale of 0100 in terms of their perceived severity (0=benign, 100=most severe)*

Injury Severity Score

N0: Neurologically intact 6

N1: Transient neurologic deficit, which is no longer present 6

N2: Radicular symptoms 6

N3: Incomplete spinal cord injury or any degree of cauda equina injury 6

N4: Complete spinal cord injury 6

NX: Neurologic status is unknown due to sedation or head injury 6

AOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScoreAOSpine TL-Classification Injury Severity ScorePlease score the following modifiers on a scale of 0100 in terms of their perceived severity (0=benign, 100=most

severe)*

Injury Severity Score

M1: This modifier is used to designate fractures with an indeterminate injury to the tension band based on spinal imaging with or without MRI. This modifier is important for designating those injuries with stable injuries from a bony standpoint for which ligamentous insufficiency may help determine whether operative stabilization is a consideration.

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M2: Is used to designate a patientspecific comorbidity, which might argue either for or against surgery for patients with relative surgical indications. Examples of an M2 modifier include ankylosing spondylitis or burns affecting the skin overlying the injured spine

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