TY - JOUR
T1 - The Diagnostic Process of Spinal Post-traumatic Deformity
T2 - An Expert Survey of 7 Cases, Consensus on Clinical Relevance Does Exist
AU - De Gendt, Erin E.A.
AU - Benneker, Lorin M.
AU - Joaquim, Andrei F.
AU - El-Sharkawi, Mohammad
AU - Dhakal, Gaurav R.
AU - Kandziora, Frank
AU - Tee, Jin
AU - Bransford, Richard J.
AU - Vialle, Emiliano N.
AU - Vaccaro, Alex R.
AU - Popescu, Eugen C.
AU - Kanna, Rishi M.
AU - Polly, David W.
AU - Schnake, Klaus J.
AU - Berjano, Pedro
AU - Ryabykh, Sergey
AU - Neva, Marko
AU - Lamartina, Claudio
AU - Rothenfluh, Dominique A.
AU - Lewis, Stephan J.
AU - Muijs, Sander P.J.
AU - Cumhur Oner, F.
N1 - Publisher Copyright:
© 2023 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Study Design: Survey of cases. Objective: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD). Summary of Background Data: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved. Methods: The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated. Results: Seventeen spinal surgeons reviewed the presented cases. The items' fracture type and complaints were rated by the participants as more important, but no agreement existed on the items of medical history. In patients with possible SPTD in the cervical spine (C) area, participants requested a conventional radiograph (CR) (76%-83%), a flexion/extension CR (61%-71%), a computed tomography (CT)-scan (76%-89%), and a magnetic resonance (MR)-scan (89%-94%). In thoracolumbar spine (ThL) cases, full spine CR (89%-100%), CT scan (72%-94%), and MR scan (65%-94%) were requested most often. There was a consensus on 5 out of 7 cases with clinically relevant SPTD (82%-100%). When consensus existed on the diagnosis of SPTD, there was a consensus on the case being compensated or decompensated and being symptomatic or asymptomatic. Conclusions: There was strong agreement in 5 out of 7 cases on the presence of the diagnosis of clinically relevant SPTD. Among spine experts, there is a strong consensus to use CT scan and MR scan, a cervical CR for C-cases, and a full spine CR for ThL-cases. The lack of agreement on items of the medical history suggests that a Delphi study can help us reach a consensus on the essential items of clinically relevant SPTD.
AB - Study Design: Survey of cases. Objective: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD). Summary of Background Data: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved. Methods: The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated. Results: Seventeen spinal surgeons reviewed the presented cases. The items' fracture type and complaints were rated by the participants as more important, but no agreement existed on the items of medical history. In patients with possible SPTD in the cervical spine (C) area, participants requested a conventional radiograph (CR) (76%-83%), a flexion/extension CR (61%-71%), a computed tomography (CT)-scan (76%-89%), and a magnetic resonance (MR)-scan (89%-94%). In thoracolumbar spine (ThL) cases, full spine CR (89%-100%), CT scan (72%-94%), and MR scan (65%-94%) were requested most often. There was a consensus on 5 out of 7 cases with clinically relevant SPTD (82%-100%). When consensus existed on the diagnosis of SPTD, there was a consensus on the case being compensated or decompensated and being symptomatic or asymptomatic. Conclusions: There was strong agreement in 5 out of 7 cases on the presence of the diagnosis of clinically relevant SPTD. Among spine experts, there is a strong consensus to use CT scan and MR scan, a cervical CR for C-cases, and a full spine CR for ThL-cases. The lack of agreement on items of the medical history suggests that a Delphi study can help us reach a consensus on the essential items of clinically relevant SPTD.
KW - consensus
KW - diagnosis
KW - spinal post-traumatic deformity
KW - spine trauma
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U2 - 10.1097/BSD.0000000000001478
DO - 10.1097/BSD.0000000000001478
M3 - Article
C2 - 37363830
AN - SCOPUS:85174080024
SN - 2380-0186
VL - 36
SP - E383-E389
JO - Clinical spine surgery
JF - Clinical spine surgery
IS - 8
ER -