Actual classifications of injuries of the thoracic and lumbar spine. Part 2. Systematic review of studies

Abstract

The study objective: to review the Russian and foreign studies and to identify an optimal classification system for thoracolumbar spine injuries.Materials and methods. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We conducted a search for articles published in English (PubMed database) and Russian (eLIBRARY.ru). The inclusion criteria were as follows: available full text, patient age ≥18 years, and information on one of the validation phases for classifications according to L. Audige et al.Results. Out of 207 abstracts, 14 articles met all the required criteria and were included into the systematic review. The F. Denis and AOSpine classifications demonstrated the highest reliability and reproducibility of the results. However, both of these classifications does not lacked predictive value to aid treatment decisions and have some other disadvantages (e. g., this classification does not address the neurologic status of the patient, and injuries of the posterior ligamentous complex (PLC)). Our analysis clearly demonstrated the need for a more thorough evaluation of all available scales and classifications.Conclusion. The F. Denis and AOSpine classifications are the most reliable and reproducible classification systems. However, these classifications have deficiencies and the data available in literature is not sufficient for a full comparison of all existing scales and systems. Further multicenter study on the reliability of classifications are needed to select an most optimal one.In order to determine the most optimal classification system in the daily routine practice, a multicenter study should be conducted with the object of determining. Further multicenter studies on the reliability of classifications are needed to select an optimal one.