The comprehensive anatomical spinal osteotomy classification.
Date
2015-03
Journal Title
Journal ISSN
Volume Title
Repository Usage Stats
views
downloads
Citation Stats
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
Department
Description
Provenance
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Schwab, Frank, Benjamin Blondel, Edward Chay, Jason Demakakos, Lawrence Lenke, Patrick Tropiano, Christopher Ames, Justin S Smith, et al. (2015). The comprehensive anatomical spinal osteotomy classification. Neurosurgery, 76 Suppl 1(Supplement 1). pp. S33–S41. 10.1227/01.neu.0000462076.73701.09 Retrieved from https://hdl.handle.net/10161/28513.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.