Cervical Spine Injury Severity Score

Study Design: A multicenter observational survey. Objective: To quantify and compare inter- and intraobserver reliability of the subaxial cervical spine injury classification (SLIC) and the cervical spine injury severity score (CSISS) in a multicentric survey of neurosurgeons with different experience levels. Methods: Data concerning 64 consecutive patients who had undergone cervical spine surgery between 2013 and 2017 was evaluated, and we surveyed 37 neurosurgeons from 7 different clinics. All raters were divided into 3 groups depending on their level of experience. Two assessment procedures were performed. Results: For the SLIC, we observed excellent agreement regarding management among experienced surgeons, whereas agreement among less experienced neurosurgeons was moderate and almost twice as unlikely. The sensitivity of SLIC relating to treatment tactics reached as high as 92.2%. For the CSISS, agreement regarding management ranged from medium to substantial, depending on a neurosurgeon’s experience. For less experienced neurosurgeons, the level of agreement concerning surgical management was the same as for the SLIC in not exceeding a moderate level. However, this scale had insufficient sensitivity (slightly exceeding 50%). The reproducibility of both scales was excellent among all raters regardless of their experience level. Conclusions: Our study demonstrated better management reliability, sensitivity, and reproducibility for the SLIC, which provided moderate interrater agreement with moderate to excellent intraclass correlation coefficient indicators for all raters. The CSISS demonstrated high reproducibility; however, large variability in answers prevented raters from reaching a moderate level of agreement. Magnetic resonance imaging integration may increase sensitivity of CSISS in relation to fracture management.

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28 The Cervical Spine Injury Severity Score (CSISS)

Spine and Spinal Cord Trauma ◽

10.1055/b-0034-81282 ◽

2011 ◽

Keyword(s):

Cervical Spine ◽

Injury Severity Score ◽

Severity Score ◽

Cervical Spine Injury ◽

Injury Severity ◽

Spine Injury

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Assessing Incidence and Risk Factors of Cervical Spine Injury in Blunt Trauma Patients Using the National Trauma Data Bank

The American Surgeon ◽

10.1177/000313481508100921 ◽

2015 ◽

Vol 81 (9) ◽

pp. 879-883 ◽

Cited By ~ 13

Author(s):

Andrew J. Young ◽

Luke Wolfe ◽

Glenn Tinkoff ◽

Therese M. Duane

Keyword(s):

Risk Factors ◽

Cervical Spine ◽

Injury Severity Score ◽

Blunt Trauma ◽

Severity Score ◽

Injury Severity ◽

Alcohol Intoxication ◽

Spine Injury ◽

Ligamentous Injury ◽

National Trauma

Despite the potentially devastating impact of missed cervical spine injuries (CI), there continues to be a large disparity in how institutions attempt to make the diagnosis. To better streamline the approach among institutions, understanding incidence and risk factors across the country is paramount. We evaluated the incidence and risk factors of CI using the National Trauma Databank for 2008 and 2009. We performed a retrospective review of the National Trauma Databank for 2008 and 2009 comparing patients with and without CI. We then performed subset analysis separating injury by patients with and without fracture and ligamentous injury. There were a total of 591,138 patients included with a 6.2 per cent incidence of CI. Regression found that age, Injury Severity Score, alcohol intoxication, and specific mechanisms of motor vehicle crash (MVC), motorcycle crash (MCC), fall, pedestrian stuck, and bicycle were independent risk factors for overall injury ( P < 0.0001). Patients with CI had longer intensive care unit (8.5 12.5 vs 5.1 7.7) and hospital lengths of stay (days) (9.6 14.2 vs 5.3 8.1) and higher mortality (1.2 per cent vs 0.3%), compared with those without injury ( P < 0.0001). There were 33,276 patient with only fractures for an incidence of 5.6 per cent and 1875 patients with ligamentous injury. Just over 6 per cent of patients suffer some form of CI after blunt trauma with the majority being fractures. Higher Injury Severity Score and MVC were consistent risk factors in both groups. This information will assist in devising an algorithm for clearance that can be used nationally allowing for more consistency among trauma providers.

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Curiosity or underdiagnosed? Thoracolumbar spinal column injuries with concomitant trauma of the pancreas

10.21203/rs.3.rs-66190/v1 ◽

2020 ◽

Author(s):

Jakob Hax ◽

Sascha Halvachizadeh ◽

Kai Oliver Jensen ◽

Till Berk ◽

Henrik Teuber ◽

...

Keyword(s):

Lumbar Spine ◽

Injury Severity Score ◽

Severity Score ◽

Injury Severity ◽

Spinal Injury ◽

Thoracolumbar Spine ◽

Pancreatic Injury ◽

Spinal Injuries ◽

Spine Injury ◽

The Mean

Abstract Background: The pancreas is an organ which is at risk of damage as a consequence of thoracolumbar spine injury. However, to our knowledge, no studies have provided any prevalence data to support this assumption. Therefore, the coincidence of pancreatic trauma in patients with spine injury is still unknown. Data from the TraumaRegister DGU® (TR-DGU) was analysed to estimate the prevalence of this correlation and to determine its influence on clinical outcome.Methods: A retrospective investigation of cases documented in the TR-DGU between 2008 and 2017 was performed. We included data of patients admitted to participating European trauma centres who had thoracic or lumbar spine injuries and met the following criteria: i) Injury Severity Score (ISS) ≥ 9, ii) blunt trauma, and iii) no early transfer out of hospital. We investigated the coincidence of pancreas injury in patients with at least an Abbreviated Injury Scale (AIS) of 2 of the thoracic or lumbar spine. Therefore, we included all kind of relevant injuries of the thoracolumbar spine.Results: In the group with thoracolumbar injury with concomitant pancreatic injury, the mean age was 43.1 ± 18.6 years, and 68% of these patients were male. The most frequent mechanisms of trauma were car (38%) and motorbike (17%) accidents, as well as high falls (23.8%). The mean Injury Severity Score was 35.7 ± 16.0 points and the in-hospital mortality rate was 17.5%. The overall prevalence of pancreatic injury was 60.7 (0.61%; 95% confidence interval (CI), 0.58–0.65) per 10,000 patients. Patients with severe spinal injuries (AIS ≥ 2) were more likely to present with a concomitant pancreatic injury compared to patients with no or only minor spinal injury (AIS 0–1) (Odds ratio (OR) 1.78; 95%CI, 1.57–2.01).Conclusions: Concomitant pancreatic injury in patients with spinal injuries of the thoracolumbar spine is rare. However, patients with more severe spinal injuries were overall more likely (OR 1.78) to present with an accompanying pancreatic injury than those with minor thoracolumbar injuries. Therefore, trauma surgeons treating severely injured patients must be alert not to overlook this rare concomitant injury, because it does not clearly correlate with the severity of spinal injury.

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