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The Global Spine Care Initiative: Classification System for Spine-Related Concerns Publisher Pubmed



Haldeman S1, 2, 3 ; Johnson CD4, 5 ; Chou R6, 7 ; Nordin M8, 9 ; Cote P10, 11 ; Hurwitz EL12 ; Green BN4, 5 ; Kopanskygiles D13, 14 ; Cedraschi C15, 16 ; Aartun E11 ; Acaroglu E17 ; Ameis A18 ; Ayhan S19 ; Blyth F20 Show All Authors
Authors
  1. Haldeman S1, 2, 3
  2. Johnson CD4, 5
  3. Chou R6, 7
  4. Nordin M8, 9
  5. Cote P10, 11
  6. Hurwitz EL12
  7. Green BN4, 5
  8. Kopanskygiles D13, 14
  9. Cedraschi C15, 16
  10. Aartun E11
  11. Acaroglu E17
  12. Ameis A18
  13. Ayhan S19
  14. Blyth F20
  15. Borenstein D21
  16. Brady OD22
  17. Davatchi F23
  18. Goertz C24, 25
  19. Hajjajhassouni N26
  20. Hartvigsen J27, 28
  21. Hondras M29
  22. Lemeunier N30
  23. Mayer J31
  24. Mior S32
  25. Mmopelwa T33
  26. Modic M34
  27. Mullerpatan R35
  28. Mwaniki L36
  29. Ngandeusingwe M37
  30. Outerbridge G38
  31. Randhawa K10, 11
  32. Sonmez E39
  33. Torres C40
  34. Torres P41
  35. Yu H10, 11
Show Affiliations
Authors Affiliations
  1. 1. Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
  2. 2. Department of Neurology, University of California, Irvine, Irvine, CA, United States
  3. 3. World Spine Care, Santa Ana, CA, United States
  4. 4. National University of Health Sciences, Lombard, IL, United States
  5. 5. Qualcomm Health Center, Stanford Health Care, San Diego, CA, United States
  6. 6. Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, United States
  7. 7. Department of Medicine, Oregon Health and Science University, Portland, OR, United States
  8. 8. Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, United States
  9. 9. World Spine Care Europe, Holmfirth, United Kingdom
  10. 10. Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
  11. 11. UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
  12. 12. Office of Public Health Studies, University of Hawai’i, Manoa, Honolulu, HI, United States
  13. 13. Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
  14. 14. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
  15. 15. Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
  16. 16. Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
  17. 17. ARTES Spine Center, Ankara, Turkey
  18. 18. Faculty of Medicine, Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
  19. 19. ARTES Spine Center, Acibadem University, Ankara, Turkey
  20. 20. Concord Clinical School, University of Sydney, Concord, NSW, Australia
  21. 21. Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, United States
  22. 22. World Spine Care, Tampa, FL, United States
  23. 23. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
  24. 24. Palmer College of Chiropractic, Davenport, IA, United States
  25. 25. The Spine Institute for Quality, Davenport, IA, United States
  26. 26. Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
  27. 27. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  28. 28. Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
  29. 29. Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
  30. 30. Institut Franco-Europeen de Chiropraxie, Toulouse, France
  31. 31. U.S. Spine and Sport Foundation, San Diego, CA, United States
  32. 32. Canadian Memorial Chiropractic College, Toronto, ON, Canada
  33. 33. ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
  34. 34. Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, United States
  35. 35. Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
  36. 36. Law Society of Kenya, Nairobi, Kenya
  37. 37. Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaounde, Center Region, Cameroon
  38. 38. World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
  39. 39. Department of Neurological Surgery, School of Medicine, Baskent University, Ankara, Turkey
  40. 40. Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  41. 41. Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
  42. 42. Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, United States
  43. 43. Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, United States

Source: European Spine Journal Published:2018


Abstract

Purpose: The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway. Methods: Existing classification systems for spinal disorders were assembled. A seed document was developed through round-table discussions followed by a modified Delphi process. International and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. Results: Thirty-six experts from 15 countries participated. After the second round, there was 95% agreement of the proposed classification system. The six major classifications included: no or minimal symptoms (class 0); mild symptoms (i.e., neck or back pain) but no interference with activities (class I); moderate or severe symptoms with interference of activities (class II); spine-related neurological signs or symptoms (class III); severe bony spine deformity, trauma or pathology (class IV); and spine-related symptoms or destructive lesions associated with systemic pathology (class V). Subclasses for each major class included chronicity and severity when different interventions were anticipated or recommended. Conclusions: An international and interprofessional group developed a comprehensive classification system for all potential presentations of people who may seek care or advice at a spine care program. This classification can be used in the development of a spine care pathway, in clinical practice, and for research purposes. This classification needs to be tested for validity, reliability, and consistency among clinicians from different specialties and in different communities and cultures. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]. © 2018, The Author(s).
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