Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System

Lambrechts, Mark J. and Schroeder, Gregory D. and Karamian, Brian A. and Canseco, Jose A. and Oner, F. Cumhur and Benneker, Lorin M. and Bransford, Richard J. and Kandziora, Frank and Rajasekaran, Shanmuganathan and El-Sharkawi, Mohammad and Kanna, Rishi and Joaquim, Andrei Fernandes and Schnake, Klaus and Kepler, Christopher K. and Vaccaro, Alexander R. and _, _ and _, _ and Asif, Dewan and Borkar, Sachin and Bakar, Joseph and Zagorac, Slavisa and Wimalachandra, Welege and Garashchuk, Oleksandr and Verdu-Lopez, Francisco and Lofrese, Giorgio and Bhatt, Pragnesh and Obadaseraye, Oke and Partenheimer, Axel and Riehle, Marion and Popescu, Eugen Cesar and Konrads, Christian and Senan, Nur Aida Faruk and Toluse, Adetunji and Neves, Nuno and Sunami, Takahiro and Kuipers, Bart and Subbiah, Jayakumar and Dyab, Anas and Loughenbury, Peter and Cawley, Derek and Schmidt, René and Kumar, Loya and Karim, Farhan and Silk, Zacharia and Parolin, Michele and Robijn, Hisco and Kalbani, Al and Rasschaert, Ricky and Müller, Christian and Nieuwenhuijse, Marc and Ayhan, Selim and Menachem, Shay and Dhatt, Sarvdeep and Khan, Nasser and Haribabu, Subramaniam and Kimani, Moses and Alarcon, Olger and Alor, Nnaemeka and Iyer, Dinesh and Ziga, Michal and Gousias, Konstantinos and Murray, Gisela and Triffaux, Michel and Hartmann, Sebastian and Yuh, Sung-Joo and Lang, Siegmund and Linn, Kyaw and Dhillon, Charanjit Singh and Hamouda, Waeel and Carnesecchi, Stefano and Kumar, Vishal and Cari, Lady Lozano and Shah, Gyanendra and Takeo, Furuya and Sartor, Federico and Gonzalez, Fernando and Dabasia, Hitesh and Liawrungrueang, Wongthawat and Liu, Lincoln and El Moudni, Younes and Yurak, Ratko and Aceituno, Héctor and Karthigeyan, Madhivanan and Demetriades, Andreas and Muthu, Sathish and Scholz, Matti and Alsammak, Wael and Chandrachari, Komal and Shan, Khoh Phaik and Trungu, Sokol and Dejaegher, Joost and Marroquin, Omar and Alexandru, Moisa Horatiu and Diez-Ulloa, Máximo-Alberto and Pereira, Paulo and Bernucci, Claudio and Hohaus, Christian and Georgiopoulos, Miltiadis and Heuer, Annika and Atan, Ahmed Arieff and Murerwa, Mark and Lindtner, Richard and Tripathi, Manjul and Kim, Huynh Hieu and Hassan, Ahmed and Foster, Norah and O’Halloran, Amanda and Kabir, Koroush and Ganau, Mario and Cruz, Daniel and Henine, Amin and Milano, Jeronimo and Mbarak, Abeid and Sousa, Arnaldo and Munjal, Satyashiva and Alkharsawi, Mahmoud and Mirza, Muhammad and Tsitsopoulos, Parmenion and Tsuang, Fon-Yih and Risenbeck, Oliver and Viswanadha, Arun-Kumar and Samy, Samer and Orosco, David and Zambito-Brondo, Gerardo and Chaudhry, Nauman and Marquez, Luis and Lepard, Jacob and Muñoz, Juan and Corluka, Stipe and Reuben, Soh and Kaen, Ariel and Ampar, Nishanth and Bigdon, Sebastien and Caba, Damián and De Miranda, Francisco and Lay, Loren and Marintschev, Ivan and Imran, Mohammed and Mohindra, Sandeep and Reddycherla, Naga Raju and Bazán, Pedro and Alhammoud, Abduljabbar and Feeley, Iain and Margetis, Konstantinos and Durst, Alexander and Jani, Ashok Kumar and Vieira, Rian Souza and Santos, Felipe and Karlin, Joshua and Montemurro, Nicola and Mlyavykh, Sergey and Sonkwe, Brian and Perovic, Darko and Lourido, Juan and Ramieri, Alessandro and Laos, Eduardo and Hadesberg, Uri and Iencean, Andrei-Stefan and Neves, Pedro and Bertolini, Eduardo and Kumar, Naresh and Bancel, Philippe and Sharma, Bishnu and Koerner, John and Neto, Eloy Rusafa and Ostadrahimi, Nima and Morillo, Olga and Rakesh, Kumar and Morakis, Andreas and Godinho, Amauri and Keerthivasan, P. and Menger, Richard and Carius, Louis and Lakhey, Rajesh Bahadur and Shiban, Ehab and Borse, Vishal and Boudreau, Elizabeth and Lacerda, Gabriel and Konstantinos, Paterakis and Saeed, Mubder Mohammed and Hasheela, Toivo and Pereira, Susana Núñez and Reidler, Jay and Rahamimov, Nimrod and Zimny, Mikolaj and Tokala, Devi Prakash and Elgafy, Hossein and Badani, Ketan and Ng, Bing Wui and Juarez, Cesar Sosa and Repantis, Thomas and Fernández-Bances, Ignacio and Kleimeyer, John and Lauper, Nicolas and Romero-Muñoz, Luis María and Yusuf, Ayodeji and Klez, Zdenek and Afolayan, John and Rutges, Joost and Grundshtein, Alon and Zaluski, Rafal and Stavridis, Stavros I. and Aoyama, Takeshi and Vachata, Petr and Urbanski, Wiktor and Tejeda, Martin and Muñiz, Luis and Karanja, Susan and Martín-Benlloch, Antonio and Torres, Heiller and Pan, Chee-Huan and Duchén, Luis and Fujioka, Yuki and Enercan, Meric and Pluderi, Mauro and Majer, Catalin and Kamath, Vijay (2023) Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System. Journal of Neurosurgery: Spine, 38 (1). pp. 31-41. ISSN 1547-5654

[thumbnail of JNS AO Spine.pdf] Text
JNS AO Spine.pdf

Download (5MB)

Abstract

OBJECTIVE

The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5–10 years, 10–20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery).
METHODS

A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson’s chi-square or Fisher’s exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility.
RESULTS

The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5–10 years: 0.69 vs 10–20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5–10 years: 0.62 vs 10–20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5–10 years: 0.61 vs 10–20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36).
CONCLUSIONS

The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system.

Item Type: Article
Subjects: AO Spine
Spine Surgery
Classification System
Divisions: Orthopaedic Surgery
Depositing User: Mr Repository Admin
Date Deposited: 09 Oct 2023 06:42
Last Modified: 27 Jun 2024 03:53
URI: https://ir.orthopaedicresearchgroup.com/id/eprint/46

Actions (login required)

View Item
View Item