Reliability and repeatability analysis of thoracolumbar AOSpine injury score and thoracolumbar injury severity score in guiding thoracolumbar fracture surgery
An Zhongcheng, Zhu Yuchen, Zhang Yingjian, Wang Guoqiang, Wei Hao, Dong Liqiang.
Abstract：Objective To evaluate the reliability and repeatability of thoracolumbar AOSpine injury score （TLAOSIS）and thoracolumbar injury severity score （TLICS） classification scoring system in guiding thoracolumbar fracture surgery, and to explore the main reasons for the consistency of classification scoring systems. Methods Fifty-five thoracolumbar fracture patients with complete clinical data and radiologic data admitted to Second Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to December 2018 were enrolled. Based on their preoperative X-ray films, CT and MRI, six physicians were assigned to independently determine the classification using the TLAOSIS and TLICS．For the same patient, the classification was identified as inconsistency among 6 observers if there was an observer in a different type．After a 4-week interval，the 55 patients were presented in a random sequence to the same evaluators for repeated evaluation．All data did not contain any marks related to the type. The Cohens Kappa coefficient was used to determine the interobserver reliability and intraobserver repeatability concerning fracture morphology, posterior ligament classification (PLC) injury classification and neurological function score. Kappa coefficients were used to observe the consistency of pre- and postmeasure measurements within each observer. Results The two classification scoring systems had good consistency and reproducibility in guiding surgery. For TLAOSIS classification scoring system, the interobserver and intraobserver Kappa values for fracture morphology were 0.806 and 0.667; neurological status were 0.937 and 0.891; PLC injury classification were 0.873 and 0.779; the final recommendation surgery were 0.816 and 0.764. For TLICS classification scoring system, the interobserver and intraobserver Kappa values for fracture morphology were 0.878 and 0.788; neurological status were 0.936 and 0.888; PLC injury classification were 0.809 and 0.691; the final recommendation surgery were 0.811 and 0.705. The two classification scoring systems were statistically significant in fracture morphology and PLC injury classification both in the reliability and repeatability analysis (P<0.05), but there was no significant difference in the neurological function score (P>0.05). Conclusions TLAOSIS and TLICS have good consistency and reproducibility in guiding surgery. The fracture morphology and PLC injury classification are the factors influencing the consistency of surgical guidance for the two classification scoring systems.
通讯作者:
董黎强， Email：dlq58@126.com， 电话：13867432797
引用本文:
安忠诚 朱宇尘 张英健 王国强 魏浩 董黎强. 胸腰椎AO脊柱损伤评分和胸腰椎损伤分型及评分指导胸腰椎骨折手术的可信度和可重复性分析[J]. 中华创伤杂志, 2020, 36(4): 296-302.
An Zhongcheng, Zhu Yuchen, Zhang Yingjian, Wang Guoqiang, Wei Hao, Dong Liqiang.. Reliability and repeatability analysis of thoracolumbar AOSpine injury score and thoracolumbar injury severity score in guiding thoracolumbar fracture surgery. CHINESE JOURNAL OF TRAUMA, 2020, 36(4): 296-302.
