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Application Of Thoracolumbar Injury Classification System(TLICS) Combined With Load Sharing Scoring System(LSC) In Guiding The Classification And Treatment Of Spinal Thoracolumbar Injury

Posted on:2022-04-15Degree:MasterType:Thesis
Country:ChinaCandidate:Y PengFull Text:PDF
GTID:2494306512964449Subject:Bone science
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Objective: To investigate the reliability of TLICS+LSC combined classification scheme in guiding the classification of spinal thoracolumbar injuries and the selection of treatment strategies,i.e.consistency and repeatability studies,and to compare it with TLICS classification system and TL AOSIS classification system in the reliability of guiding the selection of treatment options.Methods: A retrospective analysis was performed on 40 patients with thoracolumbar spinal injury admitted to our hospital from December 2018 to June 2020.First,TLICS+LSC combined classification was used to score and classify,and the consistency and repeatability were calculated.Subsequently,the same imaging data were rated according to the combined classification of TLICS+LSC,TLICS system and TL AOSIS system respectively,and treatment opinions were determined.The reliability of the suggested treatment opinions of each classification system was compared with the actual treatment plan.Results: According to the joint classification system of TLICS+LSC,region A(TLICS <4 and LSC≤6),region B(TLICS=4 and LSC≤6),region C(TLICS ≥5 and LSC≤6),region D(TLICS < 4 and LSC≥7),region E(TLICS=4 and LSC≥7),F region(TLICS≥5and LSC ≥ 7)was divided into standard vertebae.The average Kappa coefficient of consistency among 5 doctors was 0.69,and the average Kappa coefficient of repeatability between 5 doctors was 0.78.With conservative treatment(area A),conservative or surgical treatment(area B),and surgical treatment(non-A and non-B)as the standard vertebra,the average Kappa coefficient of consistency among the five doctors was calculated as 0.70,and the average Kappa coefficient of repeatability between the five doctors before and after two times was 0.79.In this study,of the 40 patients,30 received surgical treatment and 10 received conservative treatment.According to TLICS,16 patients had a score < 4,5 had a score of 4,and 19 had a score of >.The Tl AOSIS scoring criteria were <4 in 13 cases,4-5 in4 cases and > in 4 in 23 cases.TLICS+LSC combined classification showed 9 cases in region A,3 cases in region B,and 28 cases in other regions.TLICs matched the actual treatment decision in 31 cases(77.5%),TLAOSIS matched the actual treatment decision in 36 cases(90.0%),and TLICS+LSC matched the actual treatment decision in 37 cases(92.5%).Conclusions: TLICS+LSC combined classification system has good inter-observer and intra-observer reliability,and the Kappa coefficient can reach 0.70-0.79.The reliability of the recommended treatment strategies of the TLICS+LSC classification system was basically the same as that of the Tl AOSIS classification system,and both of them were superior to TLICS.It can be used as a new idea to guide the classification and treatment strategy selection of spinal thoracolumbar injury.
Keywords/Search Tags:Spinal thoracolumbar injury Classification system, Treatment strategy, Credibility and reliability
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