Accuracy and reliability of the AO Spine subaxial cervical spine classification system grading subaxial cervical facet injury morphology

2021 ◽  
Author(s):  
Juan P. Cabrera ◽  
◽  
Ratko Yurac ◽  
Alfredo Guiroy ◽  
Andrei F. Joaquim ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Subaxial Cervical Spine ◽  
Cervical Facet

scholarly journals AOSpine—Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles

2019 ◽  
Vol 9 (1_suppl) ◽  
pp. 77S-88S ◽  
Author(s):  
Srikanth N. Divi ◽  
Gregory D. Schroeder ◽  
F. Cumhur Oner ◽  
Frank Kandziora ◽  
Klaus J. Schnake ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Injury Severity ◽  
Thoracolumbar Spine ◽  
Spinal Column ◽  
Narrative Review ◽  
Patient Specific ◽  
Upper Cervical Spine ◽  
Spine Trauma ◽  
Subaxial Cervical Spine

Study Design: Narrative review. Objectives: To describe the current AOSpine Trauma Classification system for spinal trauma and highlight the value of patient-specific modifiers for facilitating communication and nuances in treatment. Methods: The classification for spine trauma previously developed by The AOSpine Knowledge Forum is reviewed and the importance of case modifiers in this system is discussed. Results: A successful classification system facilitates communication and agreement between physicians while also determining injury severity and provides guidance on prognosis and treatment. As each injury may be unique among different patients, the importance of considering patient-specific characteristics is highlighted in this review. In the current AOSpine Trauma Classification, the spinal column is divided into 4 regions: the upper cervical spine (C0-C2), subaxial cervical spine (C3-C7), thoracolumbar spine (T1-L5), and the sacral spine (S1-S5, including coccyx). Each region is classified according to a hierarchical system with increasing levels of injury or instability and represents the morphology of the injury, neurologic status, and clinical modifiers. Specifically, these clinical modifiers are denoted starting with M followed by a number. They describe unique conditions that may change treatment approach such as the presence of significant soft tissue damage, uncertainty about posterior tension band injury, or the presence of a critical disc herniation in a cervical bilateral facet dislocation. These characteristics are described in detail for each spinal region. Conclusions: Patient-specific modifiers in the AOSpine Trauma Classification highlight unique clinical characteristics for each injury and facilitate communication and treatment between surgeons.

AOSpine subaxial cervical spine injury classification system

2015 ◽  
Vol 25 (7) ◽  
pp. 2173-2184 ◽  
Author(s):  
Alexander R. Vaccaro ◽  
John D. Koerner ◽  
Kris E. Radcliff ◽  
F. Cumhur Oner ◽  
Maximilian Reinhold ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Subaxial Cervical Spine ◽  
Injury Classification

scholarly journals The classifications of subaxial cervical spine traumatic injuries. Part 4. AOSpine Subaxial Classification System

2021 ◽  
Vol 27 (1) ◽  
pp. 3-10
Author(s):  
Oleksii S. Nekhlopochyn ◽  
Ievgenii I. Slynko ◽  
Vadim V. Verbov
Keyword(s):  
Cervical Spine ◽  
Treatment Strategy ◽  
Classification System ◽  
Neurological Status ◽  
Classification Systems ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries ◽  
Injury Classification

Cervical spine injuries are a fairly common consequence of mechanical impact on the human body. The subaxial level of the cervical spine accounts for approximately half to 2/3 of these injuries. Despite the numerous classification systems that exist for describing these injuries, the recommendations for treatment strategy are very limited, and currently none of them is universal and generally accepted. Consequently, treatment decisions are based on the individual experience of the specialist, but not on evidence or algorithms. While the classification system based on the mechanism of trauma originally proposed by B.L. Allen et al. and subsequently modified by J.H. Harris Jr et al., was comprehensive, but lacked evidence, which to some extent limited its clinical applicability. Similarly, the Subaxial Injury Classification System proposed by the Spine Trauma Group, had no distinct and clinically significant patterns of morphological damage. This fact hindered the standardization and unification of tactical approaches. As an attempt to solve this problem, in 2016 Alexander Vaccaro, together with AO Spine, proposed the AO Spine subaxial cervical spine injury classification system, using the principle of already existing AOSpine classification of thoracolumbar injuries. The aim of the project was to develop an effective system that provides clear, clinically relevant morphological descriptions of trauma patterns, which should contribute to the determination of treatment strategy. The proposed classification of cervical spine injuries at the subaxial level follows the same hierarchical approach as previous AO classifications, namely, it characterizes injuries based on 4 parameters: (1) injury morphology, (2) facet damage, (3) neurological status, and (4) specific modifiers. The morphology of injuries is divided into 3 subgroups of injuries: A (compression), B (flexion-distraction), and C (dislocations and displacements). Damage types A and B are divided into 5 (A0-A4) and 3 (B1-B3) subtypes, respectively. When describing damage of the facet joints, 4 subtypes are distinguished: F1 (fracture without displacement), F2 (unstable fracture), F3 (floating lateral mass) and F4 (dislocation). The system also integrates the assessment of neurological status, which is divided into 6 subtype). In addition, the classification includes 4 specific modifiers designed to better detail a number of pathological conditions. The performance evaluation of AOSpine SCICS showed a moderate to significant range of consistency and reproducibility. Currently, a quantitative scale for assessing the severity of classification classes has been proposed, which also, to a certain extent, contributes to decision-making regarding treatment strategy.

scholarly journals The Subaxial Cervical AO Spine Injury Score

2020 ◽  
pp. 219256822097433
Author(s):  
Jose A. Canseco ◽  
Gregory D. Schroeder ◽  
Taylor M. Paziuk ◽  
Brian A. Karamian ◽  
Frank Kandziora ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Cross Sectional Survey ◽  
Injury Score ◽  
Cross Sectional ◽  
Severity Rating ◽  
Subaxial Cervical Spine ◽  
Injury Classification

Study Design: Global cross-sectional survey. Objective: To develop an injury score for the AO Spine Subaxial Cervical Spine Injury Classification System. Methods: Respondents numerically graded each variable within the classification system for severity. Based on the results, and with input from the AO Spine Trauma Knowledge Forum, the Subaxial Cervical AO Spine Injury Score was developed. Results: An A0 injury was assigned an injury score of 0, A1 a score of 1, and A2 a score of 2. Given the significant increase in severity, A3 was given a score of 4. Based on equal severity assessment, A4 and B1 were both assigned a score of 5. B2 and B3 injuries were assigned a score of 6. Unstable C-type injuries were given a score of 7. Stable F1 injuries were assigned a score of 2, with a 2-point increase for F2 injuries. Likewise, F3 injuries received a score of 5, whereas more unstable F4 injuries a score of 7. Neurologic status severity rating scores increased stepwise, with scores of 0 for N0, 1 for N1, and 2 for N2. Consistent with the Thoracolumbar AO Spine Injury Score, N3 (incomplete) and N4 (complete) injuries were given a score of 4. Finally, case-specific modifiers M1 (PLC injury) received a score of 1, while M2 (critical disc herniation) and M3 (spine stiffening disease) received a score of 4. Conclusions: The Subaxial Cervical AO Spine Injury Score is an easy-to-use metric that can help develop a surgical algorithm to supplement the AO Spine Subaxial Cervical Spine Injury Classification System.

The Subaxial Cervical Spine Injury Classification System

Spine ◽  
2007 ◽  
Vol 32 (21) ◽  
pp. 2365-2374 ◽  
Author(s):  
Alexander R. Vaccaro ◽  
R John Hulbert ◽  
Alpesh A. Patel ◽  
Charles Fisher ◽  
Marcel Dvorak ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Subaxial Cervical Spine ◽  
Injury Classification

scholarly journals AOSpine Subaxial Cervical Spine Injury Classification System

2015 ◽  
Vol 5 (1_suppl) ◽  
pp. s-0035-1554199-s-0035-1554199 ◽  
Author(s):  
Alexander Vaccaro ◽  
Christopher Kepler ◽  
John Koerner ◽  
Marcel Dvorak ◽  
Jens Chapman ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Subaxial Cervical Spine ◽  
Injury Classification
Sign in / Sign up

Export Citation Format

Share Document