title: The Thoracolumbar AOSpine Injury Score.
abstract: Study Design Survey of 100 worldwide spine surgeons. Objective To develop a spine injury score for the AOSpine Thoracolumbar Spine Injury Classification System. Methods Each respondent was asked to numerically grade the severity of each variable of the AOSpine Thoracolumbar Spine Injury Classification System. Using the results, as well as limited input from the AOSpine Trauma Knowledge Forum, the Thoracolumbar AOSpine Injury Score was developed. Results Beginning with 1 point for A1, groups A, B, and C were consecutively awarded an additional point (A1, 1 point; A2, 2 points; A3, 3 points); however, because of a significant increase in the severity between A3 and A4 and because the severity of A4 and B1 was similar, both A4 and B1 were awarded 5 points. An uneven stepwise increase in severity moving from N0 to N4, with a substantial increase in severity between N2 (nerve root injury with radicular symptoms) and N3 (incomplete spinal cord injury) injuries, was identified. Hence, each grade of neurologic injury was progressively given an additional point starting with 0 points for N0, and the substantial difference in severity between N2 and N3 injuries was recognized by elevating N3 to 4 points. Finally, 1 point was awarded to the M1 modifier (indeterminate posterolateral ligamentous complex injury). Conclusion The Thoracolumbar AOSpine Injury Score is an easy-to-use, data-driven metric that will allow for the development of a surgical algorithm to accompany the AOSpine Thoracolumbar Spine Injury Classification System.
authors.affiliation: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kepler
authors.affiliation: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.affiliation: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Schroeder
authors.affiliation: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
authors.forename: John D
authors.initials: JD
authors.lastname: Koerner
authors.affiliation: Department of Orthopaedic Surgery, Catholic University, Curitiba, Brazil.
authors.forename: Luiz R
authors.initials: LR
authors.lastname: Vialle
authors.affiliation: Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, United States.
authors.forename: Bizhan
authors.initials: B
authors.lastname: Aarabi
authors.affiliation: Department of Orthopaedic Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Shanmuganathan
authors.initials: S
authors.lastname: Rajasekaran
authors.affiliation: Department of Orthopaedic Surgery, University of Washington, Seattle, Washington, United States.
authors.forename: Carlo
authors.initials: C
authors.lastname: Bellabarba
authors.affiliation: Department of Orthopaedic Surgery, The Swedish Neuroscience Institute, Seattle, Washington, United States.
authors.forename: Jens R
authors.initials: JR
authors.lastname: Chapman
authors.affiliation: Center for Spinal Surgery and Neurotraumatology, Berufsgenossenschaftliche Unfallklinik Frankfurt, Frankfurt/Main, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Kandziora
authors.affiliation: Center for Spinal Surgery, Schön Klinik Nürnberg Fürth, Fürth, Germany.
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Schnake
authors.affiliation: Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Dvorak
authors.affiliation: Department of Orthopaedic Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Max
authors.initials: M
authors.lastname: Reinhold
authors.affiliation: Department of Orthopaedic Surgery, University Medical Center, Utrecht, The Netherlands.
authors.forename: F Cumhur
authors.initials: FC
authors.lastname: Oner
keywords: AOSpine; AOSpine injury score; TL AOSIS; thoracolumbar spine injury classification system; thoracolumbar trauma