Establishment and clinical application of thoracolumbar fracture bearing capacity scoring system
Objective:This study proposed a thoracolumbar fracture bearing capacity scoring system(TFBCSS)for thoracolumbar fracture with thoracolumbar injury classification and severity(TLICS)score of＜4 and evaluated its reliability and clinical efficacy.Methods:A retrospective analysis was conducted on patients with TLICS score＜4 who were treated for thoracolumbar fracture from December 2018 to December 2022.The TFBCSS was established based on gender,age,body mass index(BMI),and morphological changes in injured vertebrae.Five spinal surgeons(two chief physicians and three resident physicians)assigned scores to fractures based on imaging features,gender,age,and BMI.The reliability of the scoring system was evaluated.The repeatability and reliability of the TFBCSS were assessed by intra-class correlation coefficient(ICC).Patients were divided into a conservative treatment group(T＜4)and a surgical treatment group(T≥4)according to the total TFBCSS value(T).Treatment outcomes were observed based on local kyphosis angle(LAK),anterior vertebral height(AVH),visual analog scale(VAS),and oswestry disability index(ODI).Results:A total of 120 patients were retrospectively included,with 45 patients in the conservative treatment group and 75 patients in the surgical treatment group.The follow-up period ranged from 12 to 30 months,with a mean of(18.6±4.6)months.The mean ICC for the reproducibility of the TFBCSS by the 5 doctors was 0.892 in the conservative treatment group and 0.883 in the surgical treatment group,while the mean ICC for reliability was 0.891 in the conservative treatment group and 0.885 in the surgical treatment group.Both groups showed significant improvement in postoperative LKA,AVH,VAS,and ODI at the last follow-up compared to preoperative values(all P＜0.001).Conclusions:The TFBCSS can guide the clinical treatment of thoracolumbar fracture with TLICS score＜4 and has strong repeatability and consistency.
Thoracolumbar FractureThoracolumbar Injury Classification and Severity Score
万方数据
维普
