A new study published in Spine examined the classification for treating thoracolumbar fractures between two different countries.
The researchers compared the assessment and management strategies for thoracolumbar fractures between Dutch and German spine surgeons. The multicenter study included CT scans of traumatic thoracolumbar fractures with supplementary case-specific information. The surgeons used the AO-Magerl Classification and six questions concerning treatment algorithms.
There were six surgeons per country evaluating 91 cases. The researchers found:
1. Most of the fractures were classified as AO Type A (82 percent). There were also Type B cases (14 percent) and Type C (4 percent).
2. There wasn't a significant difference in AO Classification between the German and Dutch spine surgeons.
3. The German surgeons had a lower threshold for surgical indications; German surgeons recommended surgery for 87 percent of the cases, compared to 30 percent among the Dutch surgeons.
4. There was consensus for operative stabilization of the AO Type B and C injuries as well as for injuries with a neurologic deficit. However there was a discrepancy in the therapeutic algorithm for AO Type A fractures.
5. The indication for posterior and circumferential stabilization for burst fractures had the most pronounce difference between the two surgeon groups. The German surgeons indicated surgery in 96.6 percent of the posterior stabilization for burst fractures, compared with 41.2 percent of the Dutch surgeons. More than half, 53 percent, of the German surgeons indicated circumferential stabilization, compared with none of the Dutch surgeons.