This study was designed to assess the inter-observer reliability and intra-observer reproducibility of standard radiographic evaluation of 150 thoracolumbar fractures, using the Magerl (AO) classification.

Six observers (two junior and four senior residents) evaluated the radiographs. The injuries were classified by each observer as type A, B or C according to the Magerl classification system. After 3 months the injuries were again classified, this time with the addition of clinical findings of each patient. The level of agreement was measured using Cohen’s kappa test.

The overall inter-observer agreement was rated as fair (0.291) in the first session and moderate (0.403) in the second. Intra-observer values ranged from slight (0.181) to moderate (0.488).

The increased levels of agreement after the two sessions was attributed to the value of additional clinical information, the learning curve of the junior residents and the simplicity of the classification.