Subaxial injury classification system to determine the surgical approach for subaxial cervical spine injuries

2008 ◽  
Vol 19 (4) ◽  
pp. 407-410
Author(s):  
Marcel F Dvorak
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Classification System ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries ◽  
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 CURRENTLY AVAILABLE CLASSIFICATION SYSTEMS FOR LOWER CERVICAL SPINE INJURIES. PART 2. SYSTEMATIC REVIEW OF STUDIES ON THE RELIABILITY AND REPRODUCIBILITY OF EXISTING SCALES

2019 ◽  
Vol 21 (2) ◽  
pp. 28-38
Author(s):  
А. А. Grin ◽  
I. S. Lvov ◽  
S. L. Arakelyan ◽  
А. E. Talypov ◽  
А. Yu. Kordonsky ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Classification System ◽  
Small Sample ◽  
Classification Systems ◽  
Lower Cervical Spine ◽  
Study Objective ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Injury Classification

The study objective is to review the Russian and foreign studies and to identify an optimal classification system for lower cervical spine injuries. Materials and methods. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We conducted a search for articles published in English (PubMed database) and Russian (eLIBRARY.ru). The inclusion criteria were as follows: available full text, patient age ≥18 years, and information on one of the validation phases for classifications according to L. Audige et al. Results. A total of 30 articles were eligible. Of them, 3 studies were published in Russian (by one group of authors); however, they didn’t contain required statistical parameters and had duplicated data; therefore, they were excluded from the analysis. Out of 27 articles published in English, 8 articles met all the criteria and were included into the systematic review. The AOSpine and Subaxial Injury Classification Systems demonstrated the highest reliability and reproducibility of the results. The Allen–Fergusson classification has lower intraobserver and interobserver agreement coefficients, but it can give a clearer visual representation of injuries. We also assessed J. Harris classification system. The reliability of the scale developed by С. Argenson et al. was not evaluated. The analyzed publications contained no data for full evaluation of the Cervical Spine Injury Severity Score. Our analysis clearly demonstrated the need for a more thorough evaluation of all available scales and classifications. This study should be multicenter and involve experts with different levels of experience (from residents to experienced spinal surgeons). Moreover, it should analyze not only the reproducibility of individual classifications, but also the aspects of learning and the relationship between individual scales and systems. The main study limitations included insufficient number of publications, small sample sizes, heterogeneity of groups, and differences in the experience of experts. Conclusion. The AOSpine and Subaxial Injury Classification Systems are the most reliable classification systems. However, the data available in literature is not sufficient for a full comparison of all existing scales and systems. Further multicenter studies on the reliability of classifications are needed to select an optimal one.

The Surgical Approach to Subaxial Cervical Spine Injuries

Spine ◽  
2007 ◽  
Vol 32 (23) ◽  
pp. 2620-2629 ◽  
Author(s):  
Marcel F. Dvorak ◽  
Charles G. Fisher ◽  
Michael G. Fehlings ◽  
Y Raja Rampersaud ◽  
F C. Öner ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries

scholarly journals Evaluation of the SLICS use in the treatment of subaxial cervical spine injuries

2015 ◽  
Vol 73 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Halisson Y. F. da Cruz ◽  
Andrei F. Joaquim ◽  
Helder Tedeschi ◽  
Alpesh A. Patel
Keyword(s):  
Cervical Spine ◽  
Spine Injury ◽  
Spine Trauma ◽  
Severe Injuries ◽  
Cervical Spine Injuries ◽  
Results Of Treatment ◽  
Subaxial Cervical Spine ◽  
Number Of Patients ◽  
Spine Injuries ◽  
Injury Classification

The SLICS (Sub-axial Cervical Spine Injury Classification System) was proposed to help in the decision-making of sub-axial cervical spine trauma (SCST), even though the literature assessing its safety and efficacy is scarce. Method We compared a cohort series of patients surgically treated based on surgeon’s preference with patients treated based on the SLICS. Results From 2009-10, 12 patients were included. The SLICS score ranged from 2 to 9 points (mean of 5.5). Two patients had the SLICS < 4 points. From 2011-13, 28 patients were included. The SLICS score ranged from 4 to 9 points (mean of 6). There was no neurological deterioration in any group. Conclusion After using the SLICS there was a decrease in the number of patients with less severe injuries that were treated surgically. This suggests that the SLICS can be helpful in differentiating mild from severe injuries, potentially improving the results of treatment.

scholarly journals Reliability of Allen Ferguson classification versus subaxial injury classification and severity scale for subaxial cervical spine injuries: a psychometrics study

Spinal Cord ◽  
2018 ◽  
Vol 57 (1) ◽  
pp. 26-32
Author(s):  
Vijayanth Kanagaraju ◽  
P. K. Karthik Yelamarthy ◽  
Harvinder Singh Chhabra ◽  
Ajoy Prasad Shetty ◽  
Ankur Nanda ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Severity Scale ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries ◽  
Injury Classification

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

Subaxial Cervical Spine Injuries in Children and Adolescents

2015 ◽  
Vol 35 (2) ◽  
pp. 136-139 ◽  
Author(s):  
Robert F. Murphy ◽  
Austin R. Davidson ◽  
Derek M. Kelly ◽  
William C. Warner ◽  
Jeffrey R. Sawyer
Keyword(s):  
Cervical Spine ◽  
Children And Adolescents ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries
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