AO Spine Knowledge Forum Trauma and Infection

Leading the globe in generating the knowledge that improves patient care after suffering from spine trauma and infection

How AO Spine Knowledge Forum Trauma & Infection (KF T&I) improves patient care

KFT&I is a global network of spine experts dedicated to improving patient outcomes through collaborative research, classification systems, and clinical guidelines. They address key challenges and the growing health care issue of spinal trauma, advance knowledge about patterns of spinal injury and their consequences. They develop reliable classification systems based on the systematic study of all available knowledge and develop simple, clinically useful, diagnostic and therapeutic algorithms.

Practical tools for clinicians treating patients with spinal trauma and infection

These selected clinical tools and articles developed by the AO Spine Knowledge Forum Trauma & Infection will help clinicians to establish global common language, planning appropriate treatments, assessing patient suitability, training next generation surgeons, and providing the best evidence to support decision-making, ultimately enhancing clinical practice and outcomes.

AO Spine Classification systems

A unified system for classifying spinal injuries across the entire column—cervical, thoracolumbar, sacral—based on mechanical, neurological, and long-term stability. Latest spine classifications were developed for Osteoporotic Fractures and Primary Infection.

Start using the toolkits.

AO Spine Clinical Practice Recommendations (GSJ)

Published in the Global Spine Journal, these recommendations guide clinical decision-making in spinal trauma and infection, including Treatment of Pyogenic Spondylodiscitis of the Spine and Minimizing Risk of Osteoporotic Vertebral Fractures.

Access collected KF recommendations.

AO Spine outcome measures

The AO Spine patient and clinician reported outcome tools—the AO Spine PROST and CROST—are designed to measure outcomes specifically in patients sustaining injuries to their spinal column. They will allow you to compare different treatment options and predict outcomes worldwide.

Download the outcome measures.

TLA3/A4 Study—Thoracolumbar Burst Fractures

A multicenter international study comparing surgical vs non-surgical treatment for AO Spine thoracolumbar A3/A4 burst fractures without neurological deficit. Approaches vary dramatically across the globe.

Read the evidence.

Educational offerings and resources for spine professionals interested in spinal trauma and infection

AO Spine offers gold-standard courses and resources in spinal trauma and infection for spine surgeons at different stages of their career. The AO’s publishing and knowledge sharing platforms will further help boost their impact and improve the care of patients with spinal trauma and infection.

The AO Surgery Reference Trauma modules—a resource for the management of fractures, based on current clinical principles, practices and available evidence.
Global Spine Diploma Trauma module, 8-weeks, online, for recently graduated orthopedic surgeons and neurosurgeons.
AO Spine Trauma Curriculum Courses. Find your next Upcoming AO Spine Trauma course, webinar, or online event close to you.
Explore the Upcoming AO Spine Infection courses, webinars, or online events in your region or worldwide.
Guest Blog posts on Trauma. Hot topic articles, challenging cases, and latest knowledge from the AO Spine community.
Browse the latest Guest Blog posts on Infection or submit your own ideas for blog posts.
AO Videos (members access only) include digital teaching and learning material, webinars, interviews, and event coverage.
Explore AO Spine’s official journal, the Global Spine Journal with special collection with hand-picked articles on trauma and infection.
Don’t miss AO Spine’s annual Global Spine Congress, the leading international congress for spine surgeons and researchers.

Ongoing research projects

Principal investigator:

Klaus Schnake

Co-Principal investigators:

Sebastian Bigdon
Ratko Yurac

Goals:

Aims to establish international treatment recommendations to standardize treatment approaches for osteoporotic vertebral fractures and assist surgeons in better treatment decision that will promote fast mobilization and improve pain management for these patients.

Principal investigator:

Marcel Dvorak

Co-Principal investigators:

Cumhur Öner and Charlotte Dandurand

Goals:

The goal of the focus issue is to address a highly controversial topic regarding the optimal treatment of thoracolumbar burst fracture in neurologically intact patients, and to assess which factors guide surgeons in their decision-making process. Specifically, the aim is to determine the role of certain radiographic characteristics and classifications in guiding surgeons in their decision-making process and how these characteristics could be integrated into improved classifications, scoring systems and guidelines.

Principal investigator:

Cumhur Öner

Co-Principal investigator:

Said Sadiqi

Goals:

Phase 1: To investigate AO Spine PROST comprehensibility, relevance, acceptability, feasibility, and completeness among complete SCI patients.
Phase 2: To validate the extended AO Spine version among individuals with complete SCI

Principal investigator:

Richard Bransford

Co-Principal investigator:

Harvinder Chhabra

Goals:

The goal of the project to identify centers/individuals/organizations that have changed the way things are done in spine trauma care. This will be achieved through traditional bibliometric and Altmetric Attention Score (AAS) measures

Principal investigator:

Matthias Pumberger

Co-Principal investigator:

Klaus Schnake and Friederike Schömig

Goals:

Aims to validate the SISS score amongst a network of leading spine surgery experts.
Phase 1: Establish international applicable gold standard
Phase 2: Internal Validation - assess SISS reliability and accuracy and identify areas of disagreement which required further refinement.
Phase 3: International Validation - assess SISS reliability and accuracy globally
Phase 4: Dissemination

Principal investigator:
Gregory Schroeder

Co-Principal investigator:
Alexander R. Vaccaro

Goals:
To develop and validate a simple and comprehensive scheme for the classification of primary spinal infections

Phase 1: Develop a classification system for primary spinal infections incorporating clinical factors relevant for surgical decision-making.
Phase 2: Internal Validation - assess the classification's reliability and accuracy and identify areas of disagreement which required further refinement.
Phase 3: International Validation - assess the classification's reliability and accuracy globally
Phase 4: Develop a global treatment algorithm

Principal investigator:
Klaus Schnake

Goals:
To develop an easy and reliable classification system to support therapeutic decision making in Osteoporotic Vertebral-Fractures

An observational, multicenter cohort study comparing surgical versus non-surgical treatment

Principal investigator:
Marcel Dvorak

Co-Principal investigators:
Cumhur Öner

Goals:
Aims to establish and quantify the difference in the patients’ clinical outcomes after surgical treatment as compared to non-surgical treatment of thoracolumbar burst fractures within the first year after treatment with the Oswestry Disability Index (ODI)

ClinicalTrials.gov Identifier: NCT02827214

Development of a spine trauma injury classification system

Principal investigator:
Alexander R. Vaccaro

Co-Principal investigators:
Cumhur Öner

Goals:
Aims to develop and validate a comprehensive classification system of traumatic spine injuries and establish a global treatment algorithm

Phase 1: thoracolumbar system, validated
Phase 2: subaxial system, validated
Phase 3: sacral system, disseminating validated
Phase 4: upper cervical system, validation ongoing

Documents:
Classification toolkits and videos
Publication summary

* This AO Spine-sponsored study is executed with support from the AO Innovation Translation Center (AO ITC).

** Award-winning project

Completed research projects

Does erector spinae plane block decrease the amount of analgesia needed after mini-invasive posterior transpedicular stabilization in patients with vertebral body fracture. Are there any peri or postoperative complications?

Principal investigator:
Martin Holas

Co-Principal investigator:
Jakub Hlásny

Goals:
Aims to evaluate if the use of an erector spinae plane block (ESP) leads to reduction of analgesic demands in the perioperative period in patients undergoing Mini-invasive spinal surgery after fracture of the vertebral body in thoracic or lumbar spine.

AO Spine post-traumatic deformity and its relation to health-related quality of life outcomes in spine trauma (AOSpine PTDEF)

Principal investigator:
Lorin M. Benneker

Co-Principal investigators:
Gregory Schroeder
Cumhur Öner

Goals:
Aims to establish a definition for post-traumatic deformity through systematic review of the literature.
Aims to find consensus among experts on factors clinically significant to post-traumatic deformity.
Aims to understand the relationship between post-traumatic deformity and the long-term health-related quality of life outcomes measured with the ODI in patients who have undergone a traumatic injury of their spine.

Documents:
Publication summary

Principal investigator:
Alex Vaccaro

Co-Principal investigators:
Greg Schroeder

Goals:
The Spine Trauma Focus Issue aimed to synthesize the latest available knowledge regarding spine trauma and spinal cord injury controversies, AO Spine outcome instruments, AO Spine Classification systems and presentation of cases.

Documents:
Spine Trauma Focus Issue

Effect of riluzole on osteogenetic differentiation of human mesenchymal stem cells and human osteoblasts

Principal investigator:
Alex Vaccaro

Co-Principal investigators:
Cumhur Öner

Goals:
Aimed to understand the effects of Riluzole on mesenchymal stem cells' ability to convert to osteoblasts, on osteogenic differentiation, and possible toxicity of the drug on these cells

Documents:
Publication summary

The additional value of computed tomography (CT) and magnetic resonance imaging (MRI) in determining the fracture severity and management in spinal column injuries

Principal investigator:
Shanmuganathan Rajasekaran

Goals:
Aimed to define and determine the value of a CT scan and an MRI in addition to plain radiographs in a cohort of spinal fractures of various severities

Documents:
Publication summary

Development of an AO Spine trauma outcome instrument

Principal investigator:
Cumhur Öner

Goals:
Aims to develop and validate a multidisciplinary and universal outcome instrument for spinal trauma patients, which includes both the patients’ and health professionals’ perspective on health and functioning:

Phase 1: Identify the most common problems in patients with spinal trauma from the clinical and patient perspective, using the International Classification of Functioning, Disability and Health (ICF) categories as reference
Phase 2: Consensus meeting to agree on a core set of ICF categories that are relevant to measure patient reported functioning, disability and health outcomes
Phase 3: Development and validation of disease specific outcome instruments for spine trauma—AOSpine PROST and AO Spine CROST
Phase 4: Extend and validate AO Spine PROST to patients with complete traumatic spinal cord injury

Documents:
Publication summary

KF Trauma and Infection Steering Committee

Gregory D. Schroeder

Chairperson
Rothman Orthopaedic Institute,
Thomas Jefferson University
Philadelphia, USA

Klaus Schnake

Past Chairperson
Malteser Waldkrankenhaus
St. Marien, Erlangen, Germany

Mohammad El-Sharkawi

Assiut University Medical School
Assiut, Egypt

Sebastian Bigdon

Inselspital - University Hospital Bern
Bern, Switzerland

Richard Bransford

Harborview Medical Center
University of Washington
Seattle, USA

Andrei Fernandes Joaquim

University of Campinas
Campinas, Brazil

Chhabra Harvinder Singh

Sri Balaji Action Medical Institute
New Delhi, India

KF Trauma and Infection Advisory Board

Jens Chapman, Swedish Neuroscience Institute, Seattle, USA
Frank Kandziora, Unfallklinik Frankfurt, Frankfurt, Germany
Shanmuganathan Rajasekaran, Ganga Hospital, Coimbatore, India
Cumhur Öner, University Medical Centers, Utrecht, the Netherlands
Alexander R. Vaccaro, Thomas Jefferson University, Philadelphia, USA
Lorin Benneker, Sonnenhofspital Bern, University of Bern, Bern, Switzerland
Emiliano Vialle, Cajuru Hospital, Catholic University of Paraná, Curitiba, Brazil

KF Trauma and Infection Associate Members

Mohamed Aly, Prince Mohamed Ben Abdel Aziz Hospital, Saudi Arabia
Joseph Butler, Mater Misericordiae University Hospital, Dublin, Ireland
Jose A. Canseco, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, USA
Gaurav Dhakal, National Trauma Center, National Academy of Medical Sciences, Kathmandu, Nepal
Martin Holas, Teaching Hospital F. D. Roosevelt, Banská Bystrica, Slovakia
Rishi Kanna, Ganga Hospital, Coimbatore, India
Timothy A. Moore, MetroHealth Campus, Cleveland, Ohio, USA
Sander Muijs, University Medical Center Utrecht, Utrecht, the Netherlands
Marko Neva, Tampere University Hospital, Tampere, Finland
Eugen Cezar Popescu, “Prof. Dr. N. Oblu” Emergency Hospital, Iasi, Romania
Ulrich Spiegl, München Klinik Harlaching, Munich, Germany
Masahiko Takahata, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
Jin W. Tee, The Alfred Hospital, Melbourne, VA, Australia
Gaston Camino-Willhuber, Policlinica Gipuzkoa, San Sebastian, Spain
Ratko Yurac, Clínica Alemana de Santiago, Santiago, Chile
Claudius Thomé, Medical University Innsbruck, Insbruck, Austria
Julian Scherer, The University of Cape Town, Cape Town, South Africa
Charlotte Dandurand, Vancouver General Hospital, Vancouver, BC, Canada
Maximilian Reinhold, Universitätsmedizin Göttingen, Göttingen, Germany
Ahmed Abdelazim Hassan, Assiut University Medical School, Assiut, Egypt
Said Sadiqi, University Medical Center Utrecht and St. Antonius Hospital, Utrecht, the Netherlands
Brian A. Karamian, Health University of Utah, Salt Lake City, UT, USA
Vishal Kumar, PGIMER, Chandigarh, India
Atiq Uz Zaman, Ghurki Trust Teaching Hospital, Lahore, Pakistan
Grace Xiong, Stanford University, Stanford, CA, USA
Ashraf El Naga, University of California, San Francisco, CA, USA
Ory Keynan, Rambam Health Care Campus, Haifa, Israel
Alfredo Guiroy Clinica de Cuyo, Mendoza, Argentina Mendoza Argentina
Emre Yilmaz, BG University Hospital Bergmannsheil Bochum, Germany
Siegmund Lang, Universitätsklinikum Regensburg, Regensburg, Germany
Taylor Paziuk, MD. Lake Superior Spine Clinic - Orthopaedic Associates. Duluth, MN, USA.
Jonathan Neuhoff, BG Unfallklinik Frankfurt am Main, Germany

AO Spine Knowledge Forum meeting, at Global Spine Congress in 2024

Knowledge Forum Manager

Olesja Hazenbiller

Senior Project Manager