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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(02): 107-113
DOI: 10.1590/0004-282X20160200
ARTICLES

Reliability and safety of a new upper cervical spine injury treatment algorithm

Avaliação de reprodutibilidade e segurança de um novo algoritmo de tratamento das lesões cervicais altas
Andrei Fernandes Joaquim
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
2   Universidade Estadual de Campinas, Divisão de Neurocirurgia, Campinas SP, Brasil.
,
Roger Schmidt Brock
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
,
Vinicius Monteiro de Paula Guirado
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
,
Luis Henrique Sandon
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
,
Otávio Turolo da Silva
2   Universidade Estadual de Campinas, Divisão de Neurocirurgia, Campinas SP, Brasil.
,
Mário Augusto Taricco
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
,
Manoel Jacobsen Teixeira
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
,
Eberval Gadelha Figueiredo
1   Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil;
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ABSTRACT

In the present study, we evaluated the reliability and safety of a new upper cervical spine injury treatment algorithm to help in the selection of the best treatment modality for these injuries.

Methods Thirty cases, previously treated according to the new algorithm, were presented to four spine surgeons who were questioned about their personal suggestion for treatment, and the treatment suggested according to the application of the algorithm. After four weeks, the same questions were asked again to evaluate reliability (intra- and inter-observer) using the Kappa index.

Results The reliability of the treatment suggested by applying the algorithm was superior to the reliability of the surgeons’ personal suggestion for treatment. When applying the upper cervical spine injury treatment algorithm, an agreement with the treatment actually performed was obtained in more than 89% of the cases.

Conclusion The system is safe and reliable for treating traumatic upper cervical spine injuries. The algorithm can be used to help surgeons in the decision between conservative versus surgical treatment of these injuries.

RESUMO

Avaliamos a reprodutibilidade e segurança do algoritmo Upper Cervical Spine Injuries Treatment Algorithm (UCITA) recém proposto para a escolha do tratamento das lesões traumáticas da junção crânio-cervical.

Métodos Trinta casos previamente tratados de acordo com o algoritmo foram apresentados a quatro cirurgiões de coluna, sendo questionada a conduta pessoal dos mesmos e a conduta segundo a aplicação do algoritmo. Após 4 semanas, foram refeitas as mesmas perguntas para avaliar a reprodutibilidade (intra e interobservador) do algoritmo, através do índice estatístico “Kappa”.

Resultados A reprodutibilidade da conduta com o uso do algoritmo foi superior a reprodutibilidade da conduta pessoal dos cirurgiões. Com o uso do UCITA, a concordância do tratamento realmente efetivado foi encontrada em mais de 89% dos casos.

Conclusão O uso do UCITA foi seguro e reprodutível, podendo ser usado como ferramenta auxiliar na tomada de decisão entre tratamento cirúrgico versus conservador dos traumatismos da junção crâniocervical.

spinal injuries - spinal cord injuries - therapeutics - classification
traumatismos da coluna vertebral - traumatismos da medula espinal - terapêutica - classificação


Publikationsverlauf

Eingereicht: 22. September 2016

Angenommen: 09. November 2016

Artikel online veröffentlicht:
05. September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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