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Spine Injury Classification Correlates with Clinical Data

Classification system is also reliable

WEDNESDAY, May 9 (HealthDay News) -- A system to classify the severity and stability of cervical spine injuries based on fracture morphology is reliable and correlates well with clinical data, researchers report in the May issue of the Journal of Bone & Joint Surgery.

Paul A. Anderson, M.D., from the University of Wisconsin in Madison, and colleagues developed and evaluated a quantitative system to classify the stability of subaxial (C3-C7) cervical spine injuries. The system assigned a score of 0-5 based on fracture displacement and severity of ligamentous injury to the anterior, posterior, right pillar and left pillar spinal columns for a maximum score of 20 points. Fifteen examiners assigned scores to 34 patients with cervical spine injuries based on radiographs and computed tomography.

The researchers found an excellent association between the scores and clinical data. For patients with a score of 7 or greater, all patients had surgery and 11 of 14 had a neurological deficit. Only three of 20 patients with scores less than 7 had a neurological deficit. The mean intraobserver and interobserver intraclass correlation coefficients were 0.977 and 0.883, respectively.

"The Cervical Spine Injury Severity Score had excellent intraobserver and interobserver reliability," Anderson and colleagues conclude. "We believe that quantifying stability on the basis of fracture morphology will allow surgeons to better characterize these injuries and ultimately lead to the development of treatment algorithms that can be tested in clinical trials."

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