Validation of the Hierarchical Nature of the AO Spine Sacral Classification and the Development of the Sacral AO Spine Injury Score

Authors

Brian A. Karamian, Thomas Jefferson UniversityFollow
Gregory D. Schroeder, Thomas Jefferson UniversityFollow
Mark J. Lambrechts, Thomas Jefferson UniversityFollow
Jose A. Canseco, Thomas Jefferson UniversityFollow
Emiliano N. Vialle
Frank Kandziora
Lorin M. Benneker
Rajasekaran Shanmuganathan
F. Cumhur Öner
Klaus J. Schnake
Christopher K. Kepler, Thomas Jefferson UniversityFollow
Alexander R. Vaccaro, Thomas Jefferson University Hospital and The Rothman InstituteFollow

Document Type

Article

Publication Date

7-1-2023

Comments

This article is the author's final published version in Clinical Spine Surgery, Volume 36, Issue 6, July 2023, Pg. E239 - E246.

The published version is available at https://doi.org/10.1097/bsd.0000000000001437. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc..

Abstract

STUDY DESIGN: Global cross-sectional survey.

OBJECTIVE: The objective of this study was to validate the hierarchical nature of the AO Spine Sacral Classification System and develop an injury scoring system.

SUMMARY OF BACKGROUND DATA: Although substantial interobserver and intraobserver reliability of the AO Spine Sacral Classification System has been established, the hierarchical nature of the classification has yet to be validated.

METHODS: Respondents numerically graded each variable within the classification system for severity. Based on the results, a Sacral AO Spine Injury Score (AOSIS) was developed.

RESULTS: A total of 142 responses were received. The classification exhibited a hierarchical Injury Severity Score (ISS) progression (A1: 8 to C3: 95) with few exceptions. Subtypes B1 and B2 fractures showed no significant difference in ISS (B1 43.9 vs. B2 43.4, P =0.362). In addition, the transitions A3→B1 and B3→C0 represent significant decreases in ISS (A3 66.3 vs. B1 43.9, P

CONCLUSIONS: The results of this study validate the hierarchical nature of the AO Spine Sacral Classification System. The Sacral AOSIS sets the foundation for further studies to develop a universally accepted treatment algorithm for the treatment of complex sacral injuries.

LEVEL OF EVIDENCE: Level IV-Diagnostic.

Recommended Citation

Karamian, Brian A.; Schroeder, Gregory D.; Lambrechts, Mark J.; Canseco, Jose A.; Vialle, Emiliano N.; Kandziora, Frank; Benneker, Lorin M.; Shanmuganathan, Rajasekaran; Öner, F. Cumhur; Schnake, Klaus J.; Kepler, Christopher K.; and Vaccaro, Alexander R., "Validation of the Hierarchical Nature of the AO Spine Sacral Classification and the Development of the Sacral AO Spine Injury Score" (2023). Rothman Institute Faculty Papers. Paper 222.
https://jdc.jefferson.edu/rothman_institute/222

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English