Aim: Recently, AOSpine trauma knowledge forum proposed the AOSpine thoracolumbar injury
classification (AOSTLIC) system and suggested that it was reliable. However, reliability
data from additional institutions for the AOSTLIC system are not available. This study
was to examine the reliability of the AOSTLIC system in patients with thoracolumbar
(TL) fractures. Materials and Methods: Between August 2009 and June 2012, 56 patients with 74 levels traumatic TL spinal
injuries were recruited. Two classifiers, consisting of two spine surgeons, assessed
clinical and imaging data. Initially, one surgeon reviewed the data in order to classify
and calculate injury severity score according to the AOSTSIC system. This process
was repeated on a 5-week interval by another surgeon. Then we analyzed data for intra-observer
and inter-observer reliability using the kappa statistic (k). Finally, validity was
assessed using the known-groups comparison. Results: The mean age of patients was 59.5 ± 11.5 years. The k values for the AOSTSIC system
for intra-observer and inter-observer reliability ranged from 0.83 to 0.89, indicating
nearly perfect agreement agreements. Known-groups analysis showed satisfactory results.
The AOSTSIC system discriminated well between sub-groups of patients who differed
in Oswestry disability index. Conclusion: The findings showed that the morphologic classification in AOSTSIC system appears
to be reliable and reproducible classification.
Key-words:
AOSTSIC system - reliability - spine injury classification - thoracolumbar fracture
