What should an ideal spinal injury classification system consist of? A methodological review and conceptual proposal for future classifications.

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Publication year
2010Source
European Spine Journal, 19, iss. 8, (2010), pp. 1238-1249ISSN
Annotation
1 augustus 2010
Publication type
Article / Letter to editor

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Organization
Rehabilitation
Orthopaedics
Journal title
European Spine Journal
Volume
vol. 19
Issue
iss. iss. 8
Page start
p. 1238
Page end
p. 1249
Subject
NCEBP 10: Human Movement & FatigueAbstract
Since Bohler published the first categorization of spinal injuries based on plain radiographic examinations in 1929, numerous classifications have been proposed. Despite all these efforts, however, only a few have been tested for reliability and validity. This methodological, conceptual review summarizes that a spinal injury classification system should be clinically relevant, reliable and accurate. The clinical relevance of a classification is directly related to its content validity. The ideal content of a spinal injury classification should only include injury characteristics of the vertebral column, is primarily based on the increasingly routinely performed CT imaging, and is clearly distinctive from severity scales and treatment algorithms. Clearly defined observation and conversion criteria are crucial determinants of classification systems' reliability and accuracy. Ideally, two principle spinal injury characteristics should be easy to discern on diagnostic images: the specific location and morphology of the injured spinal structure. Given the current evidence and diagnostic imaging technology, descriptions of the mechanisms of injury and ligamentous injury should not be included in a spinal injury classification. The presence of concomitant neurologic deficits can be integrated in a spinal injury severity scale, which in turn can be considered in a spinal injury treatment algorithm. Ideally, a validation pathway of a spinal injury classification system should be completed prior to its clinical and scientific implementation. This review provides a methodological concept which might be considered prior to the synthesis of new or modified spinal injury classifications.
This item appears in the following Collection(s)
- Academic publications [188575]
- Electronic publications [87941]
- Faculty of Medical Sciences [74223]
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