{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:39:58Z","timestamp":1790912398448,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"AO Spine Knowledge Forum Trauma"},{"name":"AO Network Clinical Research"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective analysis of prospectively collected data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our goal was to assess radiographic characteristics associated with agreement and disagreement in treatment recommendation in thoracolumbar (TL) burst fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A panel of 22 AO Spine Knowledge Forum Trauma experts reviewed 183 cases and were asked to: (1) classify the fracture; (2) assess degree of certainty of PLC disruption; (3) assess degree of comminution; and (4) make a treatment recommendation. Equipoise threshold used was 77% (77:23 distribution of uncertainty or 17 vs 5 experts). Two groups were created: consensus vs equipoise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 183 cases reviewed, the experts reached full consensus in only 8 cases (4.4%). Eighty-one cases (44.3%) were included in the agreement group and 102 cases (55.7%) in the equipoise group. A3\/A4 fractures were more common in the equipoise group (92.0% vs 83.7%, P &lt; .001). The agreement group had higher degree of certainty of PLC disruption [35.8% (SD 34.2) vs 27.6 (SD 27.3), P &lt; .001] and more common use of the M1 modifier (44.3% vs 38.3%, P &lt; .001). Overall, the degree of comminution was slightly higher in the equipoise group [47.8 (SD 20.5) vs 45.7 (SD 23.4), P &lt; .001].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The agreement group had a higher degree of certainty of PLC injury and more common use of M1 modifier (more type B fractures). The equipoise group had more A3\/A4 type fractures. Future studies are required to identify the role of comminution in decision making as degree of comminution was slightly higher in the equipoise group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231215770","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T13:31:50Z","timestamp":1707312710000},"page":"25S-31S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Using Equipoise to Determine the Radiographic Characteristics Leading to Agreement on Best Treatment for Thoracolumbar Burst Fractures Without Neurologic Deficits"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4520-6454","authenticated-orcid":false,"given":"Charlotte","family":"Dandurand","sequence":"first","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel F.","family":"Dvorak","sequence":"additional","affiliation":[{"name":"Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olesja","family":"Hazenbiller","sequence":"additional","affiliation":[{"name":"AOSpine International, Davos, Graubunden, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Bransford","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Sports Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus J.","family":"Schnake","sequence":"additional","affiliation":[{"name":"Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany"},{"name":"Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5320-5638","authenticated-orcid":false,"given":"Lorin M.","family":"Benneker","sequence":"additional","affiliation":[{"name":"Spine Unit, Sonnenhof Spital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1157-4889","authenticated-orcid":false,"given":"Emiliano","family":"Vialle","sequence":"additional","affiliation":[{"name":"Cajuru Hospital, Catholic University of Paran\u00e1, Curitiba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-006X","authenticated-orcid":false,"given":"Shanmuganathan","family":"Rajasekaran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-7145","authenticated-orcid":false,"given":"Mohammad","family":"El-Skarkawi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4909","authenticated-orcid":false,"given":"Rishi M.","family":"Kanna","sequence":"additional","affiliation":[{"name":"Spine Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5221-8288","authenticated-orcid":false,"given":"Mohamed M.","family":"Aly","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia"},{"name":"Department of Neurosurgery, Mansoura University, Mansoura, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3763-8767","authenticated-orcid":false,"given":"Martin","family":"Holas","sequence":"additional","affiliation":[{"name":"Klinika \u00darazovej Chirurgie SZU, FNsP F.D.Roosevelta, Bansk\u00e1 Bystrica, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2152-5725","authenticated-orcid":false,"given":"Jose A.","family":"Canseco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"Muijs","sequence":"additional","affiliation":[{"name":"University Medical Centers, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-5402","authenticated-orcid":false,"given":"Eugen C.","family":"Popescu","sequence":"additional","affiliation":[{"name":"Prof. Dr. N. Oblu\u201d Emergency Hospital, Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Wee","family":"Tee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Alfred Hospital, National Trauma Research Institute (NTRI), Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5684-7679","authenticated-orcid":false,"given":"Gaston","family":"Camino-Willhuber","sequence":"additional","affiliation":[{"name":"Orthopaedic and Traumatology Department, Institute of Orthopedics \u201cCarlos E. Ottolenghi\u201d Hospital Italiano de Buenos Aires, Buenes Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-0483","authenticated-orcid":false,"given":"Andrei Fernandes","family":"Joaquim","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Department of Neurology, State University of Campinas, Campinas-Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ory","family":"Keynan","sequence":"additional","affiliation":[{"name":"Rambam Health Care Campus, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvinder Singh","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Sri Balaji Action Medical Institute, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4649-0610","authenticated-orcid":false,"given":"Sebastian","family":"Bigdon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-4192","authenticated-orcid":false,"given":"Ulrich","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cumhur F.","family":"\u00d6ner","sequence":"additional","affiliation":[{"name":"University Medical Centers, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"bibr1-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699202"},{"key":"bibr2-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003295"},{"key":"bibr3-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.03.061"},{"key":"bibr4-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-03147-9"},{"key":"bibr5-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-2157-7"},{"key":"bibr6-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005079.pub3"},{"issue":"2","key":"bibr7-21925682231215770","first-page":"115","volume":"57","author":"Ghobrial GM","year":"2013","journal-title":"J Neurosurg Sci"},{"key":"bibr8-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000656"},{"key":"bibr9-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198707163170304"},{"key":"bibr10-21925682231215770","doi-asserted-by":"publisher","DOI":"10.5455\/aim.2013.21.156-159"},{"key":"bibr11-21925682231215770","doi-asserted-by":"publisher","DOI":"10.1136\/jme.17.1.30"},{"key":"bibr12-21925682231215770","unstructured":"AOCenter Innovation Translation. Thoracolumbar Burst Fractures (AOSpine A3, A4) in Neurologically Intact Patients: An Observational, Multicenter Cohort Study Comparing Surgical versus Non-surgical Treatment. clinicaltrials.gov; 2021. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02827214. 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