Regional variability in use of a novel assessment of thoracolumbar spine fractures: United States versus international surgeons

Archie Digital Collections

Show simple item record

dc.contributor.author John Ratliff en_US
dc.contributor.author Neel Anand en_US
dc.contributor.author Alexander Vaccaro en_US
dc.contributor.author Moe Lim en_US
dc.contributor.author Joon Lee en_US
dc.contributor.author Paul Arnold en_US
dc.contributor.author James Harrop en_US
dc.contributor.author Raja Rampersaud en_US
dc.contributor.author Christopher Bono en_US
dc.contributor.author Ralf Gahr en_US
dc.contributor.author Trauma Study Group Spine en_US
dc.date.accessioned 2009-05-05T16:16:28Z
dc.date.available 2007 - en_US
dc.date.available 2009-05-05T16:16:28Z
dc.date.issued 2007-07-09 en_US
dc.identifier.citation John Ratliff;Neel Anand;Alexander Vaccaro;Moe Lim;Joon Lee;Paul Arnold;James Harrop;Raja Rampersaud;Christopher Bono;Ralf Gahr;Trauma Study Group Spine: Regional variability in use of a novel assessment of thoracolumbar spine fractures: United States versus international surgeons. World Journal of Emergency Surgery 2007, 2(1):24. en_US
dc.identifier.uri http://www.wjes.org/content/2/1/24 en_US
dc.identifier.uri http://hdl.handle.net/2271/622
dc.description.abstract BACKGROUND:Considerable variability exists in clinical approaches to thoracolumbar fractures. Controversy in evaluation and nomenclature contribute to this confusion, with significant differences found between physicians, between different specialties, and in different geographic regions. A new classification system for thoracolumbar injuries, the Thoracolumbar Injury Severity Score (TLISS), was recently described by Vaccaro. No assessment of regional differences has been described. We report regional variability in use of the TLISS system between United States and non-US surgeons.METHODS:Twenty-eight spine surgeons (8 neurosurgeons and 20 orthopedic surgeons) reviewed 56 clinical thoracolumbar injury case histories, which included pertinent imaging studies. Cases were classified and scored using the TLISS system. After a three month period, the case histories were re-ordered and the physicians repeated the exercise; 22 physicians completed both surveys and were used to assess intra-rater reliability. The reliability and treatment validity of the TLISS was assessed. Surgeons were grouped into US (n = 15) and non-US (n = 13) cohorts. Inter-rater (both within and between different geographic groups) and intra-rater reliability was assessed by percent agreement, Cohen's kappa, kappa with linear weighting, and Spearman's rank-order correlation.CONCLUSION:Non-US surgeons were found to have greater inter-rater reliability in injury mechanism, while agreement on neurological status and posterior ligamentous complex integrity tended to be higher among US surgeons. Inter-rater agreement on management was moderate, although it tended to be higher in US-surgeons. Inter-rater agreement between US and non-US surgeons was similar to within group inter-rater agreement for all categories. While intra-rater agreement for mechanism tended to be higher among US surgeons, intra-rater reliability for neurological status and PLC was slightly higher among non-US surgeons. Intra-rater reliability for management was substantial in both US and non-US surgeons. The TLISS incorporates generally accepted features of spinal injury assessment into a simple patient evaluation tool. The management recommendation of the treatment algorithm component of the TLISS shows good inter-rater and substantial intra-rater reliability in both non-US and US based spine surgeons. The TLISS may improve communication between health providers and may contribute to more efficient management of thoracolumbar injuries. en_US
dc.format.extent 346700 bytes
dc.format.extent 2910 bytes
dc.format.extent 12055 bytes
dc.format.extent 0 bytes
dc.format.extent 43 bytes
dc.format.mimetype application/pdf
dc.format.mimetype text/plain
dc.format.mimetype application/octet-stream
dc.format.mimetype application/octet-stream
dc.format.mimetype application/octet-stream
dc.language en en_US
dc.language.iso en_US
dc.publisher BioMedCentral en_US
dc.relation.ispartof 1749-7922 en_US
dc.relation.hasversion http://www.biomedcentral.com/content/pdf/1749-7922-2-24.pdf en_US
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_US
dc.title Regional variability in use of a novel assessment of thoracolumbar spine fractures: United States versus international surgeons en_US
dc.type article en_US
dc.date.captured 2009-04-27 en_US
dc.identifier.doi doi:10.1186/1749-7922-2-24 en_US
dc.identifier.pmid 17620141 en_US

Files in this item

The following license files are associated with this item:

This item appears in the following Collection(s)

Show simple item record

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Search Archie


Advanced Search

Browse

My Account

Statistics