AO Spine Knowledge Forum Trauma
Goals

AO Spine KF Trauma addresses the growing health care issue of spinal trauma with a goal to:
- improve the care of all patients with (suspected) spinal column injury;
- advance knowledge about patterns of spinal injury and their consequences;
- develop reliable classification systems based on the systematic study of all available knowledge;
- develop simple, clinically useful, diagnostic and therapeutic algorithms.
Ongoing research projects
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AO Spine Infection Classification System
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 -
‘All for All’ radiology protocol in spine trauma - STIR
Principal investigator:
Shanmuganathan Rajasekaran
Co-Principal investigators:
Pushpa Bhari Thippeswamy Rishi Kanna
Goals:
To investigate the efficacy of a single Short Tau Inversion Recovery (STIR) MRI sequence in providing sufficient information for the spine surgeon to a) classify the fracture, b) assess the presence of instability, and c) decide on the nature of treatment in patients with a thoracolumbar fracture and without neurological deficit.
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Erector Spinae Plane Block and Analgesia
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.
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AO Spine-DGOU Osteoporotic Fracture Classification System
Principal investigator:
Klaus Schnake
Goals:
To develop an easy and reliable classification system to support therapeutic decision making in Osteoporotic Vertebral-Fractures
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AO Spine Post-traumatic Deformity (PTDEF)
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 ÖnerGoals:
- 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:
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* Thoracolumbar Burst Fractures (AOSpine TLA3-A4) in Neurologically Intact Patients
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)
Documents:
Read more about the study in the AO Spine Newsletter
ClinicalTrials.gov Identifier: NCT02827214
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AO Spine Patient and Clinician-reported Spine Trauma Outcome Measures (PROST, CROST)
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 injuryDocuments:
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** AO Spine Injury Classification System
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 ongoingDocuments:
* This AO Spine-sponsored study is executed with support from the AO Innovation Translation Center (AO ITC).
** Award-winning project
Completed research projects
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AO Spine Trauma Focus Issue 2017
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:
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Effect of Riluzole on Osteogenic Differentiation
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:
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Value of CT and MRI
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:
KF Trauma Steering Committee

Klaus Schnake
Chairperson
Malteser Waldkrankenhaus
St. Marien, Erlangen, Germany

Cumhur Öner
Past Chairperson
University Medical Centers
Utrecht, the Netherlands

Alexander R. Vaccaro
Thomas Jefferson University
Philadelphia, USA

Marcel Dvorak
Vancouver General Hospital
Vancouver, Canada

Lorin Benneker
Sonnenhofspital Bern,
University of Bern
Bern, Switzerland

Emiliano Vialle
Cajuru Hospital, Catholic University of Paraná
Curitiba, Brazil

Gregory D. Schroeder
Rothman Orthopaedic Institute,
Thomas Jefferson University
Philadelphia, USA

Mohammad El-Sharkawi
Assiut University Medical School
Assiut, Egypt

Richard Bransford
Harborview Medical Center
University of Washington
Seattle, USA
KF Trauma Advisory Board

Jens Chapman
Swedish Neuroscience Institute
Seattle, USA

Frank Kandziora
Unfallklinik Frankfurt
Frankfurt, Germany

Shanmuganathan Rajasekaran
Ganga Hospital
Coimbatore, India
KF Trauma Associate Members
Sebastian Bigdon, Inselspital - University Hospital Bern, Bern, Switzerland
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
Andrei Fernandes Joaquim, University of Campinas, Campinas, Brazil
Martin Holas, Teaching Hospital F. D. Roosevelt, Banská Bystrica, Slovakia
Rishi Kanna, Ganga Hospital, Coimbatore, India
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
Philipp Schleicher, BG Unfallklinik am Main, Frankfurt, Germany
Ulrich Spiegl, Universitätsklinikum Leipzig, Leipzig, Germany
Masahiko Takahata, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
Jin W. Tee, The Alfred Hospital, Melbourne, VA, Australia
Pushpa Bhari Thippeswamy, Ganga Hospital, Coimbatore, India
Gaston Camino Willhuber, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Ratko Yurac, Clínica Alemana de Santiago, Santiago, Chile
Knowledge Forum Manager

“Simple, clinically useful, diagnostic and therapeutic algorithms will help spread knowledge and understanding of spinal injuries, reduce preventable disability, and rationalize treatment.”
Cumhur Öner, Past Chairperson KF Trauma