The Study Of Intraobserver Reproducibility Of Thoracolumbar Injury Classification And Severity Score System

Objective To evaluate the intraobsever reproducibility of the thoracolumbar injury.Methods twenty-six consecutive patients with a diagnosis of a thoracolumbar fracture were enrolled in this study.Each of these patients underwent a thorough history and serial physical examinations followed by a comprehensive radiographic evaluation consisting of plain radiographs,computed tomography scanning,and magnetic resonance imaging.Neurologic status was classified into intact,nerve root injury, complete/incomplete spinal cord/conus medullaris injury,cauda equine injury.According to the morphology in image,the fractures were classified into compression,burst,translational/rotational,distraction. According to degree of injury,posterior ligamentous complex(PLC) were sorted into intact,indeterminate,disrupted.The clinical and radiographic findings of 26 patients with thoracolumbar fratures were prospectively presented.These injuries were consecutively scored,using the TLICS.On the basis of TLICS,the decision of treatment was made.Three months later,the clinical and radiographic data for each of the cases in this series were randomly reordered and reevaluated with the same algorithm. Cohen's unweighted kappa coefficients were calculated for the key parameters of each classification system(morphology,Neurologic status, status of the PLC,total score,and proposed management) to analysis the reproducibility of TLICS.Results The interrater kappa statistics of all subgroups(morphology, status of the posterior ligaments,total score,predicted management) were within the range of moderate to substantial reliability(0.45-0.93).Kappa coefficients was 0.93 for neurologic status,high reliability.High reproducibility.Conclusions The TLICS has good reproducibility designed to simplify injury classification.