Severity Score

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Alexander R. Vaccaro - One of the best experts on this subject based on the ideXlab platform.

  • thoracolumbar spine trauma classification the thoracolumbar injury classification and Severity Score system and case examples
    Journal of Neurosurgery, 2009
    Co-Authors: Alpesh A Patel, James S. Harrop, Andrew T Dailey, Darrel S Brodke, Michael D Daubs, Peter G Whang, Alexander R. Vaccaro
    Abstract:

    Object The aim of this study was to review the Thoracolumbar Injury Classification and Severity Score (TLICS) and to demonstrate its application through a series of spine trauma cases. Methods The Spine Trauma Study Group collaborated to create and report the TLICS system. The TLICS system is reviewed and applied to 3 cases of thoracolumbar spine trauma. Results The TLICS system identifies 3 major injury characteristics to describe thoracolumbar spine injuries: injury morphology, posterior ligamentous complex integrity, and neurological status. In addition, minor injury characteristics such as injury level, confounding variables (such as ankylosing spondylitis), multiple injuries, and chest wall injuries are also identified. Each major characteristic is assigned a numerical Score, weighted by Severity of injury, which is then summated to yield the injury Severity Score. The TLICS system has demonstrated initial success and its use is increasing. Limitations of the TLICS system exist and, in some instances...

  • cervical spine injury Severity Score assessment of reliability
    Journal of Bone and Joint Surgery American Volume, 2007
    Co-Authors: Paul A. Anderson, Alexander R. Vaccaro, Christopher M. Bono, Timothy A Moore, Kirkland W Davis, Robert W Molinari, Daniel K Resnick, John R Dimar, Bizhan Aarabi, Glen Leverson
    Abstract:

    Background: Systems for classifying cervical spine injury most commonly use mechanistic or morphologic terms and do not quantify the degree of stability. Along with neurologic function, stability is a major determinant of treatment and prognosis. The goal of our study was to investigate the reliability of a method of quantifying the stability of subaxial (C3-C7) cervical spine injuries. Methods: A quantitative system was developed in which an analog Score of 0 to 5 points is assigned, on the basis of fracture displacement and Severity of ligamentous injury, to each of four spinal columns (anterior, posterior, right pillar, and left pillar). The total possible Score thus ranges from 0 to 20 points. Fifteen examiners assigned Scores after reviewing the plain radiographs and computed tomography images of thirty-four consecutive patients with cervical spine injuries. The Scores were then evaluated for interobserver and intraobserver reliability with use of intraclass correlation coefficients. Results: The mean intraobserver and interobserver intraclass correlation coefficients for the fifteen reviewers were 0.977 and 0.883, respectively. Association between the Scores and clinical data was also excellent, as all patients who had a Score of ≥7 points had surgery. Similarly, eleven of the fourteen patients with a Score of ≥7 points had a neurologic deficit compared with only three of the twenty with a Score of <7 points. Conclusions: The Cervical Spine Injury Severity Score had excellent intraobserver and interobserver reliability. 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.

  • the adoption of a new classification system time dependent variation in interobserver reliability of the thoracolumbar injury Severity Score classification system
    Spine, 2007
    Co-Authors: Alpesh A Patel, Alexander R. Vaccaro, James S. Harrop, Peter G Whang, Todd J Albert, Alan S Hilibrand, Greg D Anderson, Ashwani Sharan, Kornelius A Poelstra, Paul M Arnold
    Abstract:

    Study Design.Prospective clinical assessment of the interobserver reliability of the Thoracolumbar Injury Classification and Severity Score (TLISS) in a series of consecutive patients.Objective.To evaluate the time-dependent changes in interobserver reliability of the TLISS system.Summary of Backgro

  • Thoracolumbar injury classification and Severity Score: a new paradigm for the treatment of thoracolumbar spine trauma
    Journal of Orthopaedic Science, 2005
    Co-Authors: Joon Y. Lee, Alexander R. Vaccaro, R. John Hulbert, Rune Hedlund, James S. Harrop, Michael G. Fehlings, Moe R. Lim, F.c. Öner, Paul Arnold, Christopher M. Bono
    Abstract:

    Background Contemporary understanding of the biomechanics, natural history, and methods of treating thoracolumbar spine injuries continues to evolve. Current classification schemes of these injuries, however, can be either too simplified or overly complex for clinical use. Methods The Spine Trauma Group was given a survey to identify similarities in treatment algorithms for common thoracolumbar injuries, as well as to identify characteristics of injury that played a key role in the decision-making process. Results Based on the survey, the Spine Trauma Group has developed a classification system and an injury Severity Score (thoracolumbar injury classification and Severity Score, or TLICS), which may facilitate communication between physicians and serve as a guideline for treating these injuries. The classification system is based on the morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient. Points are assigned for each category, and the final total points suggest a possible treatment option. Conclusions The usefulness of this new system will have to be proven in future studies investigating inter- and intraobserver reliability, as well as long-term outcome studies for operative and nonoperative treatment methods.

  • The thoracolumbar injury Severity Score: a proposed treatment algorithm.
    Journal of spinal disorders & techniques, 2005
    Co-Authors: Alexander R. Vaccaro, Steven C. Zeiller, R. John Hulbert, Paul A. Anderson, Mitchel B. Harris, Rune Hedlund, James S. Harrop, Marcel F. Dvorak, Kirkham B. Wood, Michael G. Fehlings
    Abstract:

    Objective Significant controversy exists regarding the optimal management of thoracolumbar injuries. This is in part due to the lack of understanding of the natural history of various injury subtypes and the absence of a universally accepted classification scheme that facilitates communication among care providers and assists in directing treatment. The Spine Trauma Study Group has developed an injury Severity Score based on three major variables: the mechanism of injury determined by radiographic appearance, the integrity of the posterior ligamentous complex, and the neurologic status of the patient. By systematically assigning specific point values within each category based on the Severity of injury, a final Severity Score may be generated that can be used to help direct treatment. The goal of this work is to present a proposal of a detailed treatment algorithm to assist in the nonoperative or operative management of thoracolumbar injuries. Methods A detailed review of the world's spinal literature was performed to ascertain predictors of instability following thoracolumbar trauma. With use of known biomechanical and clinical outcome measures, an arbitrary assignment of point values to various injury descriptors was performed. The assessment of the validity of the Severity Score was compared retrospectively with a variety of selected cases representing the typical injury patterns under the three major injury groups: compression, translational/rotational, and distraction injuries. Conclusions The proposed treatment algorithm is an attempt to assist physicians using best-evidence medicine in managing thoracolumbar spinal injuries. The final point flow chart with graduated treatment recommendations is only preliminary and needs to be validated through prospective cohort analysis. In addition, the importance of the chosen variables determining spinal stability must also be verified.

James S. Harrop - One of the best experts on this subject based on the ideXlab platform.

  • thoracolumbar spine trauma classification the thoracolumbar injury classification and Severity Score system and case examples
    Journal of Neurosurgery, 2009
    Co-Authors: Alpesh A Patel, James S. Harrop, Andrew T Dailey, Darrel S Brodke, Michael D Daubs, Peter G Whang, Alexander R. Vaccaro
    Abstract:

    Object The aim of this study was to review the Thoracolumbar Injury Classification and Severity Score (TLICS) and to demonstrate its application through a series of spine trauma cases. Methods The Spine Trauma Study Group collaborated to create and report the TLICS system. The TLICS system is reviewed and applied to 3 cases of thoracolumbar spine trauma. Results The TLICS system identifies 3 major injury characteristics to describe thoracolumbar spine injuries: injury morphology, posterior ligamentous complex integrity, and neurological status. In addition, minor injury characteristics such as injury level, confounding variables (such as ankylosing spondylitis), multiple injuries, and chest wall injuries are also identified. Each major characteristic is assigned a numerical Score, weighted by Severity of injury, which is then summated to yield the injury Severity Score. The TLICS system has demonstrated initial success and its use is increasing. Limitations of the TLICS system exist and, in some instances...

  • the adoption of a new classification system time dependent variation in interobserver reliability of the thoracolumbar injury Severity Score classification system
    Spine, 2007
    Co-Authors: Alpesh A Patel, Alexander R. Vaccaro, James S. Harrop, Peter G Whang, Todd J Albert, Alan S Hilibrand, Greg D Anderson, Ashwani Sharan, Kornelius A Poelstra, Paul M Arnold
    Abstract:

    Study Design.Prospective clinical assessment of the interobserver reliability of the Thoracolumbar Injury Classification and Severity Score (TLISS) in a series of consecutive patients.Objective.To evaluate the time-dependent changes in interobserver reliability of the TLISS system.Summary of Backgro

  • Thoracolumbar injury classification and Severity Score: a new paradigm for the treatment of thoracolumbar spine trauma
    Journal of Orthopaedic Science, 2005
    Co-Authors: Joon Y. Lee, Alexander R. Vaccaro, R. John Hulbert, Rune Hedlund, James S. Harrop, Michael G. Fehlings, Moe R. Lim, F.c. Öner, Paul Arnold, Christopher M. Bono
    Abstract:

    Background Contemporary understanding of the biomechanics, natural history, and methods of treating thoracolumbar spine injuries continues to evolve. Current classification schemes of these injuries, however, can be either too simplified or overly complex for clinical use. Methods The Spine Trauma Group was given a survey to identify similarities in treatment algorithms for common thoracolumbar injuries, as well as to identify characteristics of injury that played a key role in the decision-making process. Results Based on the survey, the Spine Trauma Group has developed a classification system and an injury Severity Score (thoracolumbar injury classification and Severity Score, or TLICS), which may facilitate communication between physicians and serve as a guideline for treating these injuries. The classification system is based on the morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient. Points are assigned for each category, and the final total points suggest a possible treatment option. Conclusions The usefulness of this new system will have to be proven in future studies investigating inter- and intraobserver reliability, as well as long-term outcome studies for operative and nonoperative treatment methods.

  • The thoracolumbar injury Severity Score: a proposed treatment algorithm.
    Journal of spinal disorders & techniques, 2005
    Co-Authors: Alexander R. Vaccaro, Steven C. Zeiller, R. John Hulbert, Paul A. Anderson, Mitchel B. Harris, Rune Hedlund, James S. Harrop, Marcel F. Dvorak, Kirkham B. Wood, Michael G. Fehlings
    Abstract:

    Objective Significant controversy exists regarding the optimal management of thoracolumbar injuries. This is in part due to the lack of understanding of the natural history of various injury subtypes and the absence of a universally accepted classification scheme that facilitates communication among care providers and assists in directing treatment. The Spine Trauma Study Group has developed an injury Severity Score based on three major variables: the mechanism of injury determined by radiographic appearance, the integrity of the posterior ligamentous complex, and the neurologic status of the patient. By systematically assigning specific point values within each category based on the Severity of injury, a final Severity Score may be generated that can be used to help direct treatment. The goal of this work is to present a proposal of a detailed treatment algorithm to assist in the nonoperative or operative management of thoracolumbar injuries. Methods A detailed review of the world's spinal literature was performed to ascertain predictors of instability following thoracolumbar trauma. With use of known biomechanical and clinical outcome measures, an arbitrary assignment of point values to various injury descriptors was performed. The assessment of the validity of the Severity Score was compared retrospectively with a variety of selected cases representing the typical injury patterns under the three major injury groups: compression, translational/rotational, and distraction injuries. Conclusions The proposed treatment algorithm is an attempt to assist physicians using best-evidence medicine in managing thoracolumbar spinal injuries. The final point flow chart with graduated treatment recommendations is only preliminary and needs to be validated through prospective cohort analysis. In addition, the importance of the chosen variables determining spinal stability must also be verified.

Alpesh A Patel - One of the best experts on this subject based on the ideXlab platform.

  • thoracolumbar spine trauma classification the thoracolumbar injury classification and Severity Score system and case examples
    Journal of Neurosurgery, 2009
    Co-Authors: Alpesh A Patel, James S. Harrop, Andrew T Dailey, Darrel S Brodke, Michael D Daubs, Peter G Whang, Alexander R. Vaccaro
    Abstract:

    Object The aim of this study was to review the Thoracolumbar Injury Classification and Severity Score (TLICS) and to demonstrate its application through a series of spine trauma cases. Methods The Spine Trauma Study Group collaborated to create and report the TLICS system. The TLICS system is reviewed and applied to 3 cases of thoracolumbar spine trauma. Results The TLICS system identifies 3 major injury characteristics to describe thoracolumbar spine injuries: injury morphology, posterior ligamentous complex integrity, and neurological status. In addition, minor injury characteristics such as injury level, confounding variables (such as ankylosing spondylitis), multiple injuries, and chest wall injuries are also identified. Each major characteristic is assigned a numerical Score, weighted by Severity of injury, which is then summated to yield the injury Severity Score. The TLICS system has demonstrated initial success and its use is increasing. Limitations of the TLICS system exist and, in some instances...

  • the adoption of a new classification system time dependent variation in interobserver reliability of the thoracolumbar injury Severity Score classification system
    Spine, 2007
    Co-Authors: Alpesh A Patel, Alexander R. Vaccaro, James S. Harrop, Peter G Whang, Todd J Albert, Alan S Hilibrand, Greg D Anderson, Ashwani Sharan, Kornelius A Poelstra, Paul M Arnold
    Abstract:

    Study Design.Prospective clinical assessment of the interobserver reliability of the Thoracolumbar Injury Classification and Severity Score (TLISS) in a series of consecutive patients.Objective.To evaluate the time-dependent changes in interobserver reliability of the TLISS system.Summary of Backgro

Michael G. Fehlings - One of the best experts on this subject based on the ideXlab platform.

  • Thoracolumbar injury classification and Severity Score: a new paradigm for the treatment of thoracolumbar spine trauma
    Journal of Orthopaedic Science, 2005
    Co-Authors: Joon Y. Lee, Alexander R. Vaccaro, R. John Hulbert, Rune Hedlund, James S. Harrop, Michael G. Fehlings, Moe R. Lim, F.c. Öner, Paul Arnold, Christopher M. Bono
    Abstract:

    Background Contemporary understanding of the biomechanics, natural history, and methods of treating thoracolumbar spine injuries continues to evolve. Current classification schemes of these injuries, however, can be either too simplified or overly complex for clinical use. Methods The Spine Trauma Group was given a survey to identify similarities in treatment algorithms for common thoracolumbar injuries, as well as to identify characteristics of injury that played a key role in the decision-making process. Results Based on the survey, the Spine Trauma Group has developed a classification system and an injury Severity Score (thoracolumbar injury classification and Severity Score, or TLICS), which may facilitate communication between physicians and serve as a guideline for treating these injuries. The classification system is based on the morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient. Points are assigned for each category, and the final total points suggest a possible treatment option. Conclusions The usefulness of this new system will have to be proven in future studies investigating inter- and intraobserver reliability, as well as long-term outcome studies for operative and nonoperative treatment methods.

  • The thoracolumbar injury Severity Score: a proposed treatment algorithm.
    Journal of spinal disorders & techniques, 2005
    Co-Authors: Alexander R. Vaccaro, Steven C. Zeiller, R. John Hulbert, Paul A. Anderson, Mitchel B. Harris, Rune Hedlund, James S. Harrop, Marcel F. Dvorak, Kirkham B. Wood, Michael G. Fehlings
    Abstract:

    Objective Significant controversy exists regarding the optimal management of thoracolumbar injuries. This is in part due to the lack of understanding of the natural history of various injury subtypes and the absence of a universally accepted classification scheme that facilitates communication among care providers and assists in directing treatment. The Spine Trauma Study Group has developed an injury Severity Score based on three major variables: the mechanism of injury determined by radiographic appearance, the integrity of the posterior ligamentous complex, and the neurologic status of the patient. By systematically assigning specific point values within each category based on the Severity of injury, a final Severity Score may be generated that can be used to help direct treatment. The goal of this work is to present a proposal of a detailed treatment algorithm to assist in the nonoperative or operative management of thoracolumbar injuries. Methods A detailed review of the world's spinal literature was performed to ascertain predictors of instability following thoracolumbar trauma. With use of known biomechanical and clinical outcome measures, an arbitrary assignment of point values to various injury descriptors was performed. The assessment of the validity of the Severity Score was compared retrospectively with a variety of selected cases representing the typical injury patterns under the three major injury groups: compression, translational/rotational, and distraction injuries. Conclusions The proposed treatment algorithm is an attempt to assist physicians using best-evidence medicine in managing thoracolumbar spinal injuries. The final point flow chart with graduated treatment recommendations is only preliminary and needs to be validated through prospective cohort analysis. In addition, the importance of the chosen variables determining spinal stability must also be verified.

S Linn - One of the best experts on this subject based on the ideXlab platform.

  • Sorting variables for each case: a new algorithm to calculate injury Severity Score (ISS) using SPSS-PC.
    Statistics in medicine, 1996
    Co-Authors: S Linn
    Abstract:

    One of the more often used measures of multiple injuries is the injury Severity Score (ISS). Determination of the ISS is based on the abbreviated injury scale (AIS). This paper suggests a new algorithm to sort the AISs for each case and calculate ISS. The program uses unsorted abbreviated injury scale (AIS) levels for each case and rearranges them in descending order. The first three sorted AISs representing the three most severe injuries of a person are then used to calculate injury Severity Score (ISS). This algorithm should be useful for analyses of clusters of injuries especially when more patients have multiple injuries.

  • Sorting variables for each case : A new algorithm to calculate injury Severity Score (ISS) using SPSS-PC
    Statistics in Medicine, 1996
    Co-Authors: S Linn
    Abstract:

    One of the more often used measures of multiple injuries is the injury Severity Score (ISS). Determination of the ISS is based on the abbreviated injury scale (AIS). This paper suggests a new algorithm to sort the AISs for each case and calculate ISS. The program uses unsorted abbreviated injury scale (AIS) levels for each case and rearranges them in descending order. The first three sorted AISs representing the three most severe injuries of a person are then used to calculate injury Severity Score (ISS). This algorithm should be useful for analyses of clusters of injuries especially when more patients have multiple injuries. Language: en