Reliability and reproducibility analysis of the AOSpine thoracolumbar spine injury classification system by Chinese spinal surgeons.
The objective of this study was to analyze the interobserver reliability and intraobserver reproducibility of the new AOSpine thoracolumbar spine injury classification system in young Chinese orthopedic surgeons with different levels of experience in spinal trauma. Previous reports suggest that the new AOSpine thoracolumbar spine injury classification system demonstrates acceptable interobserver reliability and intraobserver reproducibility. However, there are few studies in Asia, especially in China.



The AOSpine thoracolumbar spine injury classification system was applied to 109 patients with acute, traumatic thoracolumbar spinal injuries by two groups of spinal surgeons with different levels of clinical experience. The Kappa coefficient was used to determine interobserver reliability and intraobserver reproducibility.



The overall Kappa coefficient for all cases was 0.362, which represents fair reliability. The Kappa statistic was 0.385 for A-type injuries and 0.292 for B-type injuries, which represents fair reliability, and 0.552 for C-type injuries, which represents moderate reliability. The Kappa coefficient for intraobserver reproducibility was 0.442 for A-type injuries, 0.485 for B-type injuries, and 0.412 for C-type injuries. These values represent moderate reproducibility for all injury types. The raters in Group A provided significantly better interobserver reliability than Group B (P < 0.05). There were no between-group differences in intraobserver reproducibility.



This study suggests that the new AO spine injury classification system may be applied in day-to-day clinical practice in China following extensive training of healthcare providers. Further prospective studies in different healthcare providers and clinical settings are essential for validation of this classification system and to assess its utility.
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China.
Jie
J
Cheng
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China. cheng_jie2016@163.com.
Peng
P
Liu
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China.
Dong
D
Sun
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China.
Tingzheng
T
Qin
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China.
Zikun
Z
Ma
Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130033, China.
Jingpei
J
Liu
D002681:China; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013124:Spinal Injuries / Q000145:classification / Q000175:diagnosis; D066231:Surgeons / Q000706:statistics & numerical data*; D013904:Thoracic Vertebrae / Q000293:injuries*
Consensus; Reliability; Reproducibility; Spinal injury classification; Thoracolumbar