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Alexander R. Vaccaro - One of the best experts on this subject based on the ideXlab platform.
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Surgical Decision Making for Thoracolumbar Spine Injuries in Polytrauma Patients.
Journal of Bone and Joint Surgery American Volume, 2018Co-Authors: Patrick B. Morrissey, Hamadi Murphy, Matthew M. Astolfi, Hanna Sandhu, Alexander R. VaccaroAbstract:The management of Thoracolumbar Spine injuries in patients with multiple traumatic injuries is a challenge complicated by multiple competing medical and surgical demands. Safe and effective treatment of polytrauma patients with a Thoracolumbar Spine injury requires a multidisciplinary approach that involves surgical and critical care teams. The Thoracolumbar Injury Classification and Severity Score, which was developed to facilitate consistent surgical decision making in patients with a Thoracolumbar Spine injury, provides objective criteria for the classification and management of Thoracolumbar Spine injuries. The AOSpine study group recently developed a comprehensive Thoracolumbar injury classification system that was subsequently used to create the Thoracolumbar AOSpine Injury Score, which helps guide Thoracolumbar Spine injury management via objective criteria. These scoring systems have been effectively used in clinical practice and allow for a focused and objective assessment of Thoracolumbar Spine injuries. Both the Thoracolumbar Injury Classification and Severity Score and the Thoracolumbar AOSpine Injury Score should be routinely used in treatment decision making to optimize outcomes and avoid unnecessary surgical treatment in polytrauma patients with a Thoracolumbar Spine injury.
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Reliability assessment of AOSpine Thoracolumbar Spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for Thoracolumbar Spine injuries: results of a multicentre study.
European Spine Journal, 2016Co-Authors: Rahul Kaul, Alexander R. Vaccaro, Ajoy Prasad Shetty, Harvinder Singh Chhabra, Rainer Abel, Sagun Tuli, Kali Dutta Das, Bibhudendu Mohapatra, Ankur Nanda, Gururaj SangondimathAbstract:Purpose The aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS) for Thoracolumbar Spine injuries.
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the surgical algorithm for the aoSpine Thoracolumbar Spine injury classification system
European Spine Journal, 2016Co-Authors: Alexander R. Vaccaro, Gregory D Schroeder, Christopher K Kepler, Cumhur F Oner, Luiz Roberto Vialle, Frank Kandziora, John D Koerner, Mark F Kurd, Max Reinhold, Klaus J SchnakeAbstract:Purpose The goal of the current study is to establish a surgical algorithm to accompany the AOSpine Thoracolumbar Spine injury classification system.
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establishing the injury severity of Thoracolumbar trauma confirmation of the hierarchical structure of the aoSpine Thoracolumbar Spine injury classification system
Spine, 2015Co-Authors: Gregory D Schroeder, Alexander R. Vaccaro, Christopher K Kepler, Luiz Roberto Vialle, John D Koerner, Marcel F Dvorak, Cumhur Oner, Bizhan Aarabi, Carlo Bellabarba, Michael G FehlingsAbstract:Study Design. Survey of Spine surgeons. Objective. To develop a validated regional and global injury severity scoring system for Thoracolumbar trauma. Summary of Background Data. The AOSpine Thoracolumbar Spine Injury Classification System was recently published and combines elements of both the Magerl system and the Thoracolumbar Injury Classification System; however, the injury severity of each fracture has yet to be established. Methods. A survey was sent to 100 AOSpine members from all 6 AO regions of the world (North America, South America, Europe, Africa, Asia, and the Middle East). Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System including the morphology, neurological grade, and patient specific modifiers. A grade of zero was considered to be not severe at all, and a grade of 100 was the most severe injury possible. Results. Seventy-four AOSpine surgeons from all 6 AO regions of the world numerically graded the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System to establish the injury severity score. The reported fracture severity increased significantly (P <0.0001) as the subtypes of fracture type A and type B increased, and a significant difference (P <0.0001) in severity was established for burst fractures with involvement of 2 versus 1 endplates. Finally, no regional or experiential difference in severity or classification was identified. Conclusion. Development of a globally applicable injury severity scoring system for Thoracolumbar trauma is possible. This study demonstrates no regional or experiential difference in perceived severity or Thoracolumbar Spine trauma. The AOSpine Thoracolumbar Spine Injury Classification System provides a logical approach to assessing these injuries and enables rational strategies for treatment.
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predictors of complications after spinal stabilization of Thoracolumbar Spine injuries
Journal of Trauma-injury Infection and Critical Care, 2010Co-Authors: John R Dimar, Alexander R. Vaccaro, Charles G Fisher, David O Okonkwo, Marcel F Dvorak, Michael G Fehlings, Raja Y Rampersaud, Leah Y CarreonAbstract:Background:The management of complications after major traumatic spinal injury and surgical stabilization is a challenge. The purpose of this study is to identify factors predictive of a complication after surgical stabilization of Thoracolumbar Spine injuries.Methods:A review of subjects prospectiv
Naga R. Chinapuvvula - One of the best experts on this subject based on the ideXlab platform.
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Characterization of all-terrain vehicle-related Thoracolumbar Spine injury patterns in children using the AOSpine classification system
Emergency Radiology, 2020Co-Authors: Roger W. Jordan, Nicholas M. Beckmann, Jennifer H. Johnston, Sean K. Johnston, Xu Zhang, Naga R. ChinapuvvulaAbstract:Purpose To evaluate Thoracolumbar Spine injury patterns, demographics, and clinical characteristics in pediatric patients following all-terrain vehicle-related trauma. Methods A retrospective review of patients 0–17 years old admitted to a level I trauma center following an ATV-related incident from 2004 to 2013 was performed. Thoracolumbar Spine injury patterns, accident mechanism, driver/passenger status, and demographic and clinical data were compared between patients with and without a Spine injury. Results Of 456 pediatric patients involved in ATV-related trauma, 36 sustained one or more Thoracolumbar Spine injuries (7.9%). These patients tended to be older, taller, heavier, and had a higher BMI. ATV rollover was the major statistically significant mechanism of injury to cause Spine fractures (61%). Patients with Spine injuries had twice the hospital length of stay compared with those without (4 days vs. 2 days, P = 0.003). Nonstructural Spine injuries (A0) were the most common type of injury (49.1%), followed by wedge-compression fractures (A1) (41.1%). In patients with a Thoracolumbar Spine injury, there was a mean of 3.11 Spine injuries per child. Four (10%) patients with Thoracolumbar Spine fractures also sustained a cervical Spine fracture. Conclusion Once a Thoracolumbar Spine injury has been detected in a patient, the entire spinal column should be scrutinized because there is a high likelihood for additional injuries throughout the Spine. Younger pediatric patients (≤ 8 years old) exhibit a Spine fracture pattern distinct from that of older children who have a mature osseous-ligamentous complex.
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Characterization of all-terrain vehicle-related Thoracolumbar Spine injury patterns in children using the AOSpine classification system.
Emergency Radiology, 2020Co-Authors: Roger W. Jordan, Nicholas M. Beckmann, Jennifer H. Johnston, Sean K. Johnston, Xu Zhang, Naga R. ChinapuvvulaAbstract:To evaluate Thoracolumbar Spine injury patterns, demographics, and clinical characteristics in pediatric patients following all-terrain vehicle-related trauma. A retrospective review of patients 0–17 years old admitted to a level I trauma center following an ATV-related incident from 2004 to 2013 was performed. Thoracolumbar Spine injury patterns, accident mechanism, driver/passenger status, and demographic and clinical data were compared between patients with and without a Spine injury. Of 456 pediatric patients involved in ATV-related trauma, 36 sustained one or more Thoracolumbar Spine injuries (7.9%). These patients tended to be older, taller, heavier, and had a higher BMI. ATV rollover was the major statistically significant mechanism of injury to cause Spine fractures (61%). Patients with Spine injuries had twice the hospital length of stay compared with those without (4 days vs. 2 days, P = 0.003). Nonstructural Spine injuries (A0) were the most common type of injury (49.1%), followed by wedge-compression fractures (A1) (41.1%). In patients with a Thoracolumbar Spine injury, there was a mean of 3.11 Spine injuries per child. Four (10%) patients with Thoracolumbar Spine fractures also sustained a cervical Spine fracture. Once a Thoracolumbar Spine injury has been detected in a patient, the entire spinal column should be scrutinized because there is a high likelihood for additional injuries throughout the Spine. Younger pediatric patients (≤ 8 years old) exhibit a Spine fracture pattern distinct from that of older children who have a mature osseous-ligamentous complex.
Roger W. Jordan - One of the best experts on this subject based on the ideXlab platform.
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Characterization of all-terrain vehicle-related Thoracolumbar Spine injury patterns in children using the AOSpine classification system
Emergency Radiology, 2020Co-Authors: Roger W. Jordan, Nicholas M. Beckmann, Jennifer H. Johnston, Sean K. Johnston, Xu Zhang, Naga R. ChinapuvvulaAbstract:Purpose To evaluate Thoracolumbar Spine injury patterns, demographics, and clinical characteristics in pediatric patients following all-terrain vehicle-related trauma. Methods A retrospective review of patients 0–17 years old admitted to a level I trauma center following an ATV-related incident from 2004 to 2013 was performed. Thoracolumbar Spine injury patterns, accident mechanism, driver/passenger status, and demographic and clinical data were compared between patients with and without a Spine injury. Results Of 456 pediatric patients involved in ATV-related trauma, 36 sustained one or more Thoracolumbar Spine injuries (7.9%). These patients tended to be older, taller, heavier, and had a higher BMI. ATV rollover was the major statistically significant mechanism of injury to cause Spine fractures (61%). Patients with Spine injuries had twice the hospital length of stay compared with those without (4 days vs. 2 days, P = 0.003). Nonstructural Spine injuries (A0) were the most common type of injury (49.1%), followed by wedge-compression fractures (A1) (41.1%). In patients with a Thoracolumbar Spine injury, there was a mean of 3.11 Spine injuries per child. Four (10%) patients with Thoracolumbar Spine fractures also sustained a cervical Spine fracture. Conclusion Once a Thoracolumbar Spine injury has been detected in a patient, the entire spinal column should be scrutinized because there is a high likelihood for additional injuries throughout the Spine. Younger pediatric patients (≤ 8 years old) exhibit a Spine fracture pattern distinct from that of older children who have a mature osseous-ligamentous complex.
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Characterization of all-terrain vehicle-related Thoracolumbar Spine injury patterns in children using the AOSpine classification system.
Emergency Radiology, 2020Co-Authors: Roger W. Jordan, Nicholas M. Beckmann, Jennifer H. Johnston, Sean K. Johnston, Xu Zhang, Naga R. ChinapuvvulaAbstract:To evaluate Thoracolumbar Spine injury patterns, demographics, and clinical characteristics in pediatric patients following all-terrain vehicle-related trauma. A retrospective review of patients 0–17 years old admitted to a level I trauma center following an ATV-related incident from 2004 to 2013 was performed. Thoracolumbar Spine injury patterns, accident mechanism, driver/passenger status, and demographic and clinical data were compared between patients with and without a Spine injury. Of 456 pediatric patients involved in ATV-related trauma, 36 sustained one or more Thoracolumbar Spine injuries (7.9%). These patients tended to be older, taller, heavier, and had a higher BMI. ATV rollover was the major statistically significant mechanism of injury to cause Spine fractures (61%). Patients with Spine injuries had twice the hospital length of stay compared with those without (4 days vs. 2 days, P = 0.003). Nonstructural Spine injuries (A0) were the most common type of injury (49.1%), followed by wedge-compression fractures (A1) (41.1%). In patients with a Thoracolumbar Spine injury, there was a mean of 3.11 Spine injuries per child. Four (10%) patients with Thoracolumbar Spine fractures also sustained a cervical Spine fracture. Once a Thoracolumbar Spine injury has been detected in a patient, the entire spinal column should be scrutinized because there is a high likelihood for additional injuries throughout the Spine. Younger pediatric patients (≤ 8 years old) exhibit a Spine fracture pattern distinct from that of older children who have a mature osseous-ligamentous complex.
Gregory D Schroeder - One of the best experts on this subject based on the ideXlab platform.
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the surgical algorithm for the aoSpine Thoracolumbar Spine injury classification system
European Spine Journal, 2016Co-Authors: Alexander R. Vaccaro, Gregory D Schroeder, Christopher K Kepler, Cumhur F Oner, Luiz Roberto Vialle, Frank Kandziora, John D Koerner, Mark F Kurd, Max Reinhold, Klaus J SchnakeAbstract:Purpose The goal of the current study is to establish a surgical algorithm to accompany the AOSpine Thoracolumbar Spine injury classification system.
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establishing the injury severity of Thoracolumbar trauma confirmation of the hierarchical structure of the aoSpine Thoracolumbar Spine injury classification system
Spine, 2015Co-Authors: Gregory D Schroeder, Alexander R. Vaccaro, Christopher K Kepler, Luiz Roberto Vialle, John D Koerner, Marcel F Dvorak, Cumhur Oner, Bizhan Aarabi, Carlo Bellabarba, Michael G FehlingsAbstract:Study Design. Survey of Spine surgeons. Objective. To develop a validated regional and global injury severity scoring system for Thoracolumbar trauma. Summary of Background Data. The AOSpine Thoracolumbar Spine Injury Classification System was recently published and combines elements of both the Magerl system and the Thoracolumbar Injury Classification System; however, the injury severity of each fracture has yet to be established. Methods. A survey was sent to 100 AOSpine members from all 6 AO regions of the world (North America, South America, Europe, Africa, Asia, and the Middle East). Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System including the morphology, neurological grade, and patient specific modifiers. A grade of zero was considered to be not severe at all, and a grade of 100 was the most severe injury possible. Results. Seventy-four AOSpine surgeons from all 6 AO regions of the world numerically graded the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System to establish the injury severity score. The reported fracture severity increased significantly (P <0.0001) as the subtypes of fracture type A and type B increased, and a significant difference (P <0.0001) in severity was established for burst fractures with involvement of 2 versus 1 endplates. Finally, no regional or experiential difference in severity or classification was identified. Conclusion. Development of a globally applicable injury severity scoring system for Thoracolumbar trauma is possible. This study demonstrates no regional or experiential difference in perceived severity or Thoracolumbar Spine trauma. The AOSpine Thoracolumbar Spine Injury Classification System provides a logical approach to assessing these injuries and enables rational strategies for treatment.
Michael G Fehlings - One of the best experts on this subject based on the ideXlab platform.
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establishing the injury severity of Thoracolumbar trauma confirmation of the hierarchical structure of the aoSpine Thoracolumbar Spine injury classification system
Spine, 2015Co-Authors: Gregory D Schroeder, Alexander R. Vaccaro, Christopher K Kepler, Luiz Roberto Vialle, John D Koerner, Marcel F Dvorak, Cumhur Oner, Bizhan Aarabi, Carlo Bellabarba, Michael G FehlingsAbstract:Study Design. Survey of Spine surgeons. Objective. To develop a validated regional and global injury severity scoring system for Thoracolumbar trauma. Summary of Background Data. The AOSpine Thoracolumbar Spine Injury Classification System was recently published and combines elements of both the Magerl system and the Thoracolumbar Injury Classification System; however, the injury severity of each fracture has yet to be established. Methods. A survey was sent to 100 AOSpine members from all 6 AO regions of the world (North America, South America, Europe, Africa, Asia, and the Middle East). Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System including the morphology, neurological grade, and patient specific modifiers. A grade of zero was considered to be not severe at all, and a grade of 100 was the most severe injury possible. Results. Seventy-four AOSpine surgeons from all 6 AO regions of the world numerically graded the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System to establish the injury severity score. The reported fracture severity increased significantly (P <0.0001) as the subtypes of fracture type A and type B increased, and a significant difference (P <0.0001) in severity was established for burst fractures with involvement of 2 versus 1 endplates. Finally, no regional or experiential difference in severity or classification was identified. Conclusion. Development of a globally applicable injury severity scoring system for Thoracolumbar trauma is possible. This study demonstrates no regional or experiential difference in perceived severity or Thoracolumbar Spine trauma. The AOSpine Thoracolumbar Spine Injury Classification System provides a logical approach to assessing these injuries and enables rational strategies for treatment.
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predictors of complications after spinal stabilization of Thoracolumbar Spine injuries
Journal of Trauma-injury Infection and Critical Care, 2010Co-Authors: John R Dimar, Alexander R. Vaccaro, Charles G Fisher, David O Okonkwo, Marcel F Dvorak, Michael G Fehlings, Raja Y Rampersaud, Leah Y CarreonAbstract:Background:The management of complications after major traumatic spinal injury and surgical stabilization is a challenge. The purpose of this study is to identify factors predictive of a complication after surgical stabilization of Thoracolumbar Spine injuries.Methods:A review of subjects prospectiv
