AO Spine Knowledge Forum Trauma and Infection

Systematically bringing the world on the same page

Goals

KF Trauma Vegas 2022 AO Spine KF Trauma at the Global Spine Congress 2022 in Las Vegas, Nevada, USA

AO Spine KF Trauma and Infection 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

  • The osteoporotic fracture classification–based scoring system for treatment decision in thoracolumbar osteoporotic fractures: An international multicenter prospective study (TL-OF)

    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.


  • What motivates treatment decisions in Neurologically intact patients with thoracolumbar burst fractures

    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.


  • Extension and applicability of the AO Spine PROST to spinal cord injury patients

    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


  • Assessment of the worlds contribution to spine trauma care

    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


  • Development and Validation of a Disc Injury AOS-DIS

    Principal investigator:

    Lorin Benneker

    Co-Principal investigator:

    Sebastian Bigdon

    Goals:

    Current classifications and treatment guidelines for thoracolumbar fractures only rely on the bony and ligamentous structures of the spine and leave out the intervertebral disc completely, even though in most fractures (A3 and worse) some disc injury is given by definition. The aim of this project is to investigate prognostic factors for posttraumatic disc degeneration at initial imaging and to assess the importance of the disc injury on radiological and clinical outcome.

    Phase 1: Establish important parameters to be included in the DIS score through systematic review and modified Delphi process
    Phase 2: Internal and International validation of the DIS score
    Phase 3: Test the applicability of the DIS score in a prospective multicenter observational study


  • Spinal Instability Spondylodiscitis Score (SISS)

    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


  • AO Spine Primary 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

  • 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

  • * 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

  • ** 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 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

  • 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.

  • 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 Öner

    Goals:

    1. Aims to establish a definition for post-traumatic deformity through systematic review of the literature.
    2. Aims to find consensus among experts on factors clinically significant to post-traumatic deformity.
    3. 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

  • 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:

    Spine Trauma Focus Issue

  • 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:

    Publication summary

  • 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:

    Publication summary

  • 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 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

Richard Bransford
Harborview Medical Center
University of Washington
Seattle, USA

Chabra Harvinder Singh

Chhabra Harvinder Singh
Sri Balaji Action Medical Institute
New Delhi, India

A Joaquim

Andrei Fernandes Joaquim
University of Campinas
Campinas, Brazil

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

Marcel Dvorak
Vancouver General Hospital
Vancouver, Canada

KF Trauma and Infection Associate Members

Mohamed Aly, Prince Mohamed Ben Abdel Aziz Hospital, Saudi Arabia
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
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
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 
Gaston Camino Willhuber, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Ratko Yurac, Clínica Alemana de Santiago, Santiago, Chile
Claudius Thomé, Medical University Innsbruck, Insbruck, Austria 
Matthias Pumberger, Charité - Universitätsmedizin, Berlin, Germany
Julian Scherer, The University of Cape Town, Cape Town, South Africa
Charlotte Dandurand, Vancouver General Hospital, Vacouver, 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

Knowledge Forum Manager

Olesja Hazenbiller
Senior Project Manager

Other Knowledge Forums

AO Spine KF Tumor

AO Spine KF Deformity

AO Spine KF Spinal Cord Injury (SCI)

AO Spine KF Degenerative

“Facing new challenges in spinal trauma deserves up to date recommendations for diagnostics and treatment. We are closing the gap between beliefs and evidence.”

Klaus Schnake, Chairperson KF Trauma and Infection, Chair-elect AO Spine Research Commission