方法:病例调查。
目的:评估专家在临床相关脊柱创伤后畸形(SPTD)诊断过程中的意见。
背景:SPTD是脊柱创伤的潜在并发症,可导致功能下降和生活质量受损。SPTD何时成为临床相关的问题尚未解决。
方法:将7例病例调查送31名专家。病例介绍是病史,诊断评估,诊断评估的评估,诊断,和治疗选择。意味着,范围,参与者的百分比,并计算描述性统计数据。
结果:17名脊柱外科医生回顾了这些病例。项目\'骨折类型和投诉被评为更重要的参与者,但在病史项目上没有一致意见。在颈椎(C)区域可能存在SPTD的患者中,参与者要求常规X光片(CR)(76%-83%),屈伸CR(61%-71%),计算机断层扫描(CT)扫描(76%-89%),和磁共振(MR)扫描(89%-94%)。在胸腰椎(ThL)病例中,全脊柱CR(89%-100%),CT扫描(72%-94%),最常要求MR扫描(65%-94%)。7例中有5例与临床相关的SPTD(82%-100%)达成共识。当关于SPTD的诊断存在共识时,对于该病例已获得补偿或失代偿且有症状或无症状,已达成共识。
结论:7例病例中有5例诊断为临床相关的SPTD。在脊柱专家中,使用CT扫描和MR扫描有很强的共识,C病例的宫颈CR,ThL病例的完整脊柱CR。在病史项目上缺乏共识,这表明Delphi研究可以帮助我们就临床相关的SPTD的基本项目达成共识。
方法:V级
Survey of cases.
To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD).
SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved.
The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated.
Seventeen spinal surgeons reviewed the presented cases. The items\' fracture type and complaints were rated by the participants as more important, but no agreement existed on the items of medical history. In patients with possible SPTD in the cervical spine (C) area, participants requested a conventional radiograph (CR) (76%-83%), a flexion/extension CR (61%-71%), a computed tomography (CT)-scan (76%-89%), and a magnetic resonance (MR)-scan (89%-94%). In thoracolumbar spine (ThL) cases, full spine CR (89%-100%), CT scan (72%-94%), and MR scan (65%-94%) were requested most often. There was a
consensus on 5 out of 7 cases with clinically relevant SPTD (82%-100%). When
consensus existed on the diagnosis of SPTD, there was a
consensus on the case being compensated or decompensated and being symptomatic or asymptomatic.
There was strong agreement in 5 out of 7 cases on the presence of the diagnosis of clinically relevant SPTD. Among spine experts, there is a strong
consensus to use CT scan and MR scan, a cervical CR for C-cases, and a full spine CR for ThL-cases. The lack of agreement on items of the medical history suggests that a Delphi study can help us reach a
consensus on the essential items of clinically relevant SPTD.
Level V.