TABLE 7.
Intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on years of surgical experience and surgical subspecialty
| Agreement | Surgical Experience |
Surgical Subspecialty |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| <5 yrs | 5–10 yrs | 11–20 yrs | >20 yrs | p Value | Orthopedic Spine Surgery | Neurosurgery | p Value* | Other | |
| Overall classification |
|
|
|
|
|
|
|
|
|
| Slight |
1 (2.0) |
3 (5.1) |
1 (1.6) |
0 |
0.57 |
4 (3.2) |
1 (1.3) |
0.65 |
0 |
| Fair |
2 (4.1) |
0 |
5 (8.0) |
3 (8.6) |
0.83 |
7 (5.7) |
3 (3.9) |
0.74 |
0 |
| Moderate |
6 (12.2) |
11 (18.7) |
9 (14.3) |
6 (17.1) |
0.81 |
17 (13.7) |
14 (18.2) |
0.51 |
1 (20) |
| Substantial |
16 (32.7) |
23 (39.0) |
28 (44.4) |
12 (34.3) |
0.59 |
42 (33.9) |
34 (44.2) |
0.19 |
3 (60) |
| Excellent |
24 (49.0) |
22 (37.3) |
20 (31.8) |
14 (40.0) |
0.32 |
54 (43.5) |
25 (32.5) |
0.16 |
1 (20) |
| Injury location |
|
|
|
|
|
|
|
|
|
| Slight |
0 |
2 (3.4) |
2 (3.2) |
0 |
0.55 |
3 (2.4) |
1 (1.3) |
1.0 |
0 |
| Fair |
0 |
1 (1.7) |
1 (1.6) |
0 |
1.0 |
2 (1.6) |
0 |
0.53 |
0 |
| Moderate |
2 (4.1) |
2 (3.4) |
4 (6.4) |
2 (5.7) |
0.86 |
7 (5.6) |
3 (3.9) |
0.74 |
0 |
| Substantial |
6 (12.2) |
3 (5.1) |
6 (9.5) |
2 (5.7) |
0.55 |
10 (8.1) |
6 (7.8) |
1.0 |
1 (20) |
| Excellent |
41 (83.7) |
51 (86.4) |
50 (79.4) |
31 (88.6) |
0.61 |
102 (82.3) |
67 (87.0) |
0.49 |
4 (80) |
| Injury type |
|
|
|
|
|
|
|
|
|
| Slight |
2 (4.1) |
2 (3.4) |
3 (4.8) |
1 (2.9) |
1.0 |
7 (5.6) |
1 (1.3) |
0.16 |
0 |
| Fair |
1 (2.0) |
5 (8.5) |
3 (4.8) |
1 (2.9) |
0.53 |
5 (4.0) |
5 (6.5) |
0.51 |
0 |
| Moderate |
9 (18.4) |
12 (20.3) |
14 (22.2) |
12 (34.3) |
0.34 |
19 (15.3) |
25 (32.5) |
0.007
|
3 (60) |
| Substantial |
19 (38.8) |
19 (32.2) |
25 (39.7) |
10 (28.6) |
0.63 |
48 (38.7) |
24 (31.2) |
0.35 |
1 (20) |
| Excellent | 18 (36.7) | 21 (35.6) | 18 (28.6) | 11 (31.4) | 0.78 | 45 (36.3) | 22 (28.6) | 0.33 | 1 (20) |
Agreement is indicated as follows: slight (< 0.2), fair (0.2–0.4), moderate (0.41–0.60), substantial (0.61–0.8), and excellent (0.81–1.0). Values are given as number of surgeons evaluated (%) unless otherwise indicated. Both surveys were completed by 206 surgeons. Boldface type indicates statistical significance (p < 0.05).
*
Comparison between orthopedic surgeons and neurosurgeons.