Agreement between orthopedic surgeons and neurosurgeons regarding a new algorithm for the treatment of thoracolumbar injuries: a multicenter reliability study

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Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Dailey, Andrew T.
Other Author Rampersaud, Y. Raja; Fisher, Charles; Wilsey, Jared; Arnold, Paul; Anand, Neel; Bono, Chris M.; Dvorak, Marcel; Fehlings, Michael G.; Harrop, James S.; Oner, F. C.; Vaccaro, Alexander R.
Title Agreement between orthopedic surgeons and neurosurgeons regarding a new algorithm for the treatment of thoracolumbar injuries: a multicenter reliability study
Date 2006
Description Introduction: Considerable variability exists in the management of thoracolumbar (TL) spine injuries. Although there are many influences, one significant factor may be the treating surgeon's specialty and training (ie, orthopedic surgery vs. neurosurgery). Our objective was to assess the agreement between spinal orthopedic and neurologic surgeons in rating the severity of TL spine injuries with a new treatment algorithm. This information could be important in establishing consensus-based protocols for managing these challenging injuries. Methods: Twenty-eight spinal surgeons (8 neurosurgeons and 20 orthopedic surgeons) reviewed 56 TL injury case histories. Each case was classified and scored according to the TL injury severity score (TLISS). The case histories were reordered and the physicians repeated the exercise 3 months later. At both intervals the surgeons were asked if they agreed with the final treatment recommendation of the TLISS algorithm. The reliability and decision validity of the TLISS was compared. Results: Between-group interrater reliability was similar to within group reliabilities. Intrarater reliability was also similar between groups. The between speciality interrater reliability of the TLISS management recommendation was moderate (74% agreement, k=0.532). Orthopedic and neurosurgeons agreed with the TLISS management recommendation 91.4% and 94.4% of the time, respectively. Conclusions: The TLISS demonstrated good reliability in terms of intraobserver and interobserver agreement on the algorithmic treatment recommendations. The recommendation for operation seems to be consistent between fellowship-trained orthopedic and neurosurgical spine surgeons. This type of classification system may reduce the existing variability and initial management decision for treatment of TL injuries.
Type Text
Publisher Wolters Kluwer (LWW)
Volume 19
Issue 7
First Page 477
Last Page 482
Subject Thoracolumbar injuries; Rating; Classification; TLISS; Neurosurgery; Interspeciality reliability
Subject LCSH Spine -- Wounds and injuries; Orthopedic surgery
Language eng
Bibliographic Citation Rampersaud, Y. R., Fisher, C., Wilsey, J., Arnold, P., Anand, N., Bono, C. M., Dailey, A. T., Dvorak, M., Fehlings, M. G., Harrop, J. S., Oner, F. C., & Vaccaro, A. R. (2006). Agreement between orthopedic surgeons and neurosurgeons regarding a new algorithm for the treatment of thoracolumbar injuries: a multicenter reliability study. Journal of Spinal Disorders and Techniques, 19(7), 477-82.
Rights Management (c) Wolters Kluwer (LWW) http://lww.com
Format Medium application/pdf
Format Extent 109,135 bytes
Identifier ir-main,13180
ARK ark:/87278/s64m9p30
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 706479
Reference URL https://collections.lib.utah.edu/ark:/87278/s64m9p30
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