دورية أكاديمية

Variations in management of A3 and A4 cervical spine fractures as designated by the AO Spine Subaxial Injury Classification System

التفاصيل البيبلوغرافية
العنوان: Variations in management of A3 and A4 cervical spine fractures as designated by the AO Spine Subaxial Injury Classification System
المؤلفون: Kweh B.T.S., Tee J.W., Muijs S., Oner F.C., Schnake K.J., Benneker L.M., Vialle E.N., Kanziora F., Rajasekaran S., Schroeder G., Vaccaro A.R., Grin A., Abdelgawaad A.S., Zubairi A.J., Castillo A., Lezica A.V., Ramieri A., Guiroy A., Grundshtein A., Godinho A., Jr, Henine A., Pershin A.A., Athanasiou A., Zarate-Kalfopulos B., Benzarti S., Bernucci C., Rebholz B.J., Direito-Santos B., Costa B.L., Saciloto B., Majer C., Tannoury C., Cheng C., Cheung J.P.Y., Konrads C., Jetjumnong C., Chung C.K., Popescu E.C., Kilinçer C., Harrism C.B., Steiner C.D., Igualada C., Perovic D., Picazo D.R., Falcone L.D.O., Gopalakrishnan D., Ankit D., Tokala D.P., Karmacharya B., Lotan R., Shoaib M., Russo S., Viswanadha A.K., Garg B., Uribe N.D., Medina F., Subbiah J., Alsammak W., Mandizvidza V., Atan A.A., Barani R., Sámano H.V., Pemovska E.S., Hinojosa F.C.L., Fang T., Landriel F., Sartor F.D., De Oliveira Ferreira M.V., Fiorenza V., Mannara F.A., Franz S., Freedman B.A., Grozman S.A.M., Espinosa G., Ricciardi G.A., Ponnusamy G., Amadou H.A., Romero I., Rutges J., Harrop J., Sauri-Barraza J.-C., Sharma J.K., Arbatin J.J.F., Jr, Milano J.B., Francis J.J., Li Tat J.C., Vahl J., Corredor J.A., Morais J.M., Guasque J., Koerner J., Johnny D., Ron J.R.P., Delgado-Fernandez J., Montoya J.E.M., Lourido J., Kaen A., Özdener K.M., Margetis K., Paterakis K., Cari L.L., Fu L., Dawoud A., Luna L.M., Alkharsawi M., Diez-Ulloa M.-A., García-Pallero M.A., Pluderi M., Gruenberg M., Valacco M., Ganau M., Estefan M.M., Rodríguez L.M.D., Miyakoshi N., Elshamly M., Khattab M.F., Smith S.R., Abeid M., Garfinkel I., Nicassio N., Neves N., Acosta O.C.M., Bazán P.L., Pereira P., Lim P., Pritchard P.R., Bhatt P., Kundangar R., Vieira R.S., Rodrigues-Pinto R., Panchal R.R., Llombart-Blanco R., Rosas R.A.R., Manilha R., Yurac R., Diniz S., Wagner S.C., Fuego S., Ramakrishnan S., Demiröz S., Hackla S., Shariati B., El-Sharkawi M., Sorimachi Y., Corluka S., Yuh S.-J., Benzakour T., ElHewala T., Suri T., Cawley D.T., Toluse A., Valdez C., Abdul W., Hassan W., Robinson Y., Hickman Z.L., Amin M.Z.H.M., Guerra O.G., Klezl Z., the AO Spine Subaxial Injury Classification System Validation Group
المصدر: Journal of Neurosurgery: Spine ; https://www.scopus.com/inward/record.uri?eid=2-s2.0-85124916122&doi=10.3171%2f2021.3.SPINE201997&partnerID=40&md5=d01db641a07dfed4bd38523a8688ad2bTest
بيانات النشر: American Association of Neurological Surgeons
سنة النشر: 2022
مصطلحات موضوعية: adult, Africa, algorithm, Article, Asia, burst fracture, cervical spine fracture, cervical spine injury, comorbidity, disease classification, Europe, human, Middle East, neurologic disease, neurosurgeon, North America, pain severity, South America, vignette, cervical vertebra, clinical practice, fracture fixation, injury, injury scale, orthosis, patient selection, questionnaire, spine fracture, Cervical Vertebrae, Humans
الوصف: OBJECTIVE Optimal management of A3 and A4 cervical spine fractures, as defined by the AO Spine Subaxial Injury Classification System, remains controversial. The objectives of this study were to determine whether significant management variations exist with respect to 1) fracture location across the upper, middle, and lower subaxial cervical spine and 2) geographic region, experience, or specialty. METHODS A survey was internationally distributed to 272 AO Spine members across six geographic regions (North America, South America, Europe, Africa, Asia, and the Middle East). Participants’ management of A3 and A4 subaxial cervical fractures across cervical regions was assessed in four clinical scenarios. Key characteristics considered in the vignettes included degree of neurological deficit, pain severity, cervical spine stability, presence of comorbidities, and fitness for surgery. Respondents were also directly asked about their preferences for operative management and misalignment acceptance across the subaxial cervical spine. RESULTS In total, 155 (57.0%) participants completed the survey. Pooled analysis demonstrated that surgeons were more likely to offer operative intervention for both A3 (p < 0.001) and A4 (p < 0.001) fractures located at the cervicothoracic junction compared with fractures at the upper or middle subaxial cervical regions. There were no significant variations in management for junctional incomplete (p = 0.116) or complete (p = 0.342) burst fractures between geographic regions. Surgeons with more than 10 years of experience were more likely to operatively manage A3 (p < 0.001) and A4 (p < 0.001) fractures than their younger counterparts. Neurosurgeons were more likely to offer surgical stabilization of A3 (p < 0.001) and A4 (p < 0.001) fractures than their orthopedic colleagues. Clinicians from both specialties agreed regarding their preference for fixation of lower junctional A3 (p = 0.866) and A4 (p = 0.368) fractures. Overall, surgical fixation was recommended more often .
نوع الوثيقة: article in journal/newspaper
اللغة: English
العلاقة: http://hdl.handle.net/11615/75549Test
الإتاحة: http://hdl.handle.net/11615/75549Test
حقوق: undefined
رقم الانضمام: edsbas.54C616F
قاعدة البيانات: BASE