| Summary: | Introduction: The trans-intervertebral approach for degenerative disc disease is widely used but rarely described for deformity correction. Resarch Question: The objective of this study is to propose a trans-intervertebral osteotomy (TIO) classification for posterior spinal osteotomy procedures via the intervertebral space. Material and Methods: TIO classification divides posterior spinal corrective osteotomy procedures via the intervertebral space into 3 main types and 2 plus subtypes according to the resected portion. Reliability and validity were evaluated by a measurement of 40 consecutive patients from January 2014 to December 2019 with CT scans and other data, which were classified according to the proposed classification twice by 5 different spine surgeons. The intraclass correlation coefficient and kappa correlation coefficients were calculated. Results: For TIO classification, the test showed an overall intraclass correlation coefficient value for interobserver reliability of 0.915 (95% CI 0.859-0.971) in the first test and of 0.943 (95% CI 0.887-0.999) in the second test. The intraclass correlation coefficient for intraobserver reliability was 0.927 to 0.964. The validity of the classification results was almost perfect, with kappa correlation coefficients of 0.893 to 0.964. Discussion and Conclusion: Based on both pre- and postoperative CT scans, TIO classification has excellent reliability and validity and is a reliable tool to help manage rigid malalignment and spinal deformities of various etiologies.
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