胸腰椎骨折新旧分类的观察者内及观察者间可重复性
Intraobserver and interobserver reproducibility of the old and new classifications of toracolombar fractures.
作者信息
Lopes Felipe Augusto Rozales, Ferreira Ana Paula Ribeiro Bonilauri, Santos Ricardo André Acácio Dos, Maçaneiro Carlos Henrique
机构信息
Instituto de Ortopedia e Traumatologia de Joinville, Joinville, SC, Brazil.
出版信息
Rev Bras Ortop. 2018 Aug 2;53(5):521-526. doi: 10.1016/j.rboe.2018.07.015. eCollection 2018 Sep-Oct.
OBJECTIVE
To evaluate the inter and intraobserver agreement of the Magerl AO and AOSpine thoracolumbar fracture classification systems.
METHODS
The participants were divided into two groups, the first composed of six spinal surgeons and the other composed of 18 medical orthopedic residents. On two different occasions, separated by an interval of one month, the participants analyzed and classified 25 radiographs with thoracolumbar fractures using both thoracolumbar fracture classification systems, Magerl AO and AOSpine. The results were analyzed for classification reliability using the Kappa coefficient ().
RESULTS
The Magerl AO classification system showed a fair interobserver agreement ( = 0.32), considering the fractures type and subtype, whereas the AOSpine classification system showed a moderate interobserver agreement ( = 0.59). The Magerl AO classification showed a fair intraobserver agreement for both residents and specialists ( = 0.21 and 0.38, respectively), while the AOSpine showed a substantial agreement between residents ( = 0.62) and moderate between specialists ( = 0.53).
CONCLUSIONS
When evaluating fracture morphology, the AOSpine thoracolumbar fracture classification system presented a better reliability and reproducibility compared to the Magerl AO classification system.
目的
评估马格勒AO（Magerl AO）和AO脊柱胸腰椎骨折分类系统在观察者间及观察者内的一致性。
方法
参与者分为两组，第一组由六名脊柱外科医生组成，另一组由18名骨科住院医师组成。在两个不同的时间点，间隔一个月，参与者使用马格勒AO和AO脊柱胸腰椎骨折分类系统对25张胸腰椎骨折的X线片进行分析和分类。使用kappa系数（κ）分析结果的分类可靠性。
结果
考虑骨折类型和亚型，马格勒AO分类系统显示出一般的观察者间一致性（κ = 0.32），而AO脊柱分类系统显示出中等的观察者间一致性（κ = 0.59）。马格勒AO分类在住院医师和专家中均显示出一般的观察者内一致性（分别为κ = 0.21和0.38），而AO脊柱分类在住院医师中显示出较高的一致性（κ = 0.62），在专家中显示出中等的一致性（κ = 0.53）。
结论
在评估骨折形态时，与马格勒AO分类系统相比，AO脊柱胸腰椎骨折分类系统具有更好的可靠性和可重复性。
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