The comprehensive anatomical spinal osteotomy classification.
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2014-01
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Abstract
Background
Global sagittal malalignment is significantly correlated with health-related quality-of-life scores in the setting of spinal deformity. In order to address rigid deformity patterns, the use of spinal osteotomies has seen a substantial increase. Unfortunately, variations of established techniques and hybrid combinations of osteotomies have made comparisons of outcomes difficult.Objective
To propose a classification system of anatomically-based spinal osteotomies and provide a common language among spine specialists.Methods
The proposed classification system is based on 6 anatomic grades of resection (1 through 6) corresponding to the extent of bone resection and increasing degree of destabilizing potential. In addition, a surgical approach modifier is added (posterior approach or combined anterior and posterior approaches). Reliability of the classification system was evaluated by an analysis of 16 clinical cases, rated 2 times by 8 different readers, and calculation of Fleiss kappa coefficients.Results
Intraobserver reliability was classified as "almost perfect"; Fleiss kappa coefficient averaged 0.96 (range, 0.92-1.0) for resection type and 0.90 (0.71-1.0) for the approach modifier. Results from the interobserver reliability for the classification were 0.96 for resection type and 0.88 for the approach modifier.Conclusion
This proposed anatomically based classification system provides a consistent description of the various osteotomies performed in spinal deformity correction surgery. The reliability study confirmed that the classification is simple and consistent. Further development of its use will provide a common frame for osteotomy assessment and permit comparative analysis of different treatments.Type
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Schwab, Frank, Benjamin Blondel, Edward Chay, Jason Demakakos, Lawrence Lenke, Patrick Tropiano, Christopher Ames, Justin S Smith, et al. (2014). The comprehensive anatomical spinal osteotomy classification. Neurosurgery, 74(1). pp. 112–120. 10.1227/neu.0000000000000182o Retrieved from https://hdl.handle.net/10161/28769.
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