title: Concordance in the radiological diagnosis of thoracolumbar spine fractures.
abstract: BACKGROUND
  Thoracolumbar spine fractures are frequent and severe. Early diagnosis and appropriate treatment to obtain good clinical results is essential, with many classifications being proposed for this purpose.
  
  
  OBJECTIVE
  To determine the external validity of radiographic and computed tomography (CT) measurements for the most used classifications, and decide on the type of treatment required. The working hypothesis is the existence of external validity of radiographic measurements.
  
  
  METHODS
  A sample of patients with thoracolumbar fracture was selected. Three spine specialists and a resident performed measurements on anteroposterior and lateral radiographic images as well as coronal, sagittal and axial CT slices. Fractures were classified as stable or unstable, evaluating the degree of intra-and interobserver agreement based on a standard observer. Sagittal index of Farcy, lateral wedging, Beck Index, traumatic regional angulation and channel occupancy were studied.
  
  
  RESULTS
  All indicators studied, except the lateral wedging, showed a high degree of concordance.
  
  
  CONCLUSIONS
  Instability determinants studied with radiographs and CT, which had obtained statistical significance, are reliable and accurate for the classification of thoracolumbar fractures and, therefore, to indicate an appropriate treatment.
authors.affiliation: Departamento de Traumatología y Cirugía Ortopédica, Hospital Universitario Costa del Sol, Universidad de Málaga, Marbella, Málaga, España. Electronic address: miguelhirschfeld@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Hirschfeld
authors.affiliation: Departamento de Traumatología y Cirugía Ortopédica, Hospital Universitario Costa del Sol, Universidad de Málaga, Marbella, Málaga, España.
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Departamento de Traumatología y Cirugía Ortopédica, Hospital Universitario Costa del Sol, Universidad de Málaga, Marbella, Málaga, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Cerván
authors.affiliation: Departamento de Traumatología y Cirugía Ortopédica, Hospital Universitario Costa del Sol, Universidad de Málaga, Marbella, Málaga, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Ortega
authors.affiliation: Unidad de Investigación, Agencia Sanitaria Costa del Sol, Red de Investigación en Servicios de Salud y Enfermedades Crónicas REDISSEC, Marbella, Málaga, España.
authors.forename: F
authors.initials: F
authors.lastname: Rivas-Ruiz
authors.affiliation: Departamento de Traumatología y Cirugía Ortopédica, Hospital Universitario Costa del Sol, Universidad de Málaga, Marbella, Málaga, España.
authors.forename: E
authors.initials: E
authors.lastname: Guerado
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000145:classification / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Diagnosis; Diagnóstico; Fracturas de raquis; Interobserver variability; Intraobserver variability; Spine fractures; Variabilidad interobservador; Variabilidad intraobservador