Assignment Task
Abstract.
AO Spine TL classification for fractures of the thoracolumbar vertebrae is the most commonly used classification in everyday clinical practice. It refers to injuries of the thoracolumbar segment of the spine. Lumbar vertebra. These injuries occur as a result of a force acting on an axial axis through the spine and a flexion / extension force on the same segment. The most common cause of injury to this segment of the spine is a fall from a height, a car accident, much less often a direct fall or impact, as well as in multi-traumatized and polytraumatized patients. This type of vertebral fracture accounts for about 40 to 45 percent of all vertebral fractures. But despite their frequency, there is still uncertainty about the choice of treatment for these injuries, non-surgical versus surgical treatment. These dilemmas are supported in the literature by studies in which some authors prefer the advantage of surgical treatment emphasizing patient satisfaction in terms of pain relief, better and faster rehabilitation, better functional results. However, there are authors who in their studies show the advantage of conservative treatment with good functional results and a small percentage of complications and morbidity. Developing, creating a widely accepted, comprehensive and simple classification system for thoracolumbar fractures of the spine with clinically acceptable internal observational and mutual observational reliability for use in day-to-day clinical practice and research is a necessity. Existing known and applied classification systems, Dennis classification, Magerel classification and thoracolumbar injury classification (TLICS) are well known, but have not achieved wider international application. Lack of coordination between surgeons / researchers complicates research and studies on these injuries, as well as the development of algorithms for their treatment. The AO Spine-thoracolumbar fractures (AO Spine TL) injury classification system is based on widely accepted international compliance among surgeons / researchers, making this classification system simpler, more usable, more reliable and more applicable. Contains three main components: morphological classification of the fracture, a system for assessing neurological status, and a description of relevant patient-specific modifiers. The aim of this research is to investigate whether the system for classification of thoracolumbar fractures of the spine AO ??Spine TL can be implemented and applied in the daily work of the clinic for PHI TOARILUC. To confirm the reliability of the new AO Spine TL classification for thoracolumbar vertebral fractures in patients with or without neurological deficit, with or without ligament lesions. Does the AO Spine TL system allow the detection of those types of injuries that are difficult for surgeons to classify reliably? The decision-making process for the type of treatment, as well as the outcome of our alignment of appropriate treatment decisions (operative versus non-operative) is in order to establish a surgical algorithm that would accompany the AO Spine TL system for the classification of thoracolumbar spine injuries. The study is intended to be an internal observational study of reliability and applicability, as well as an evaluation of the reproducibility of the AO Spine TL classification. for PHI TOARILUC, performed in two analyzes. At a mutual time interval of two months, individually, independently of each other, and a third analysis independently by the lead researcher. The research was conducted at the Clinic for Traumatology and covers 40 patients with fractures of the thoracolumbar segment of the spine, in the period from February 2015 to January 2019. Patients who meet the inclusion or exclusion criteria will be included or excluded in the study. The results for the reliability and applicability of the AO Spine TL classification will be analyzed using the Kappa Fliesh (?) coefficient. The process of decision-making for treatment choice, compliance for treatment choice, as well as the formation of an algorithm that would accompany the AO Spine TL classification will be analyzed. All patients will be analyzed and the radiological parameters for sagittal deformity present in thoracolumbar fractures, by the lead researcher.
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