Document Detail


The development and evaluation of the subaxial injury classification scoring system for cervical spine trauma.
MedLine Citation:
PMID:  20857247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Fractures and dislocations of the subaxial cervical spine may give rise to devastating consequences. Previous algorithms for describing cervical trauma largely depend on retrospective reconstructions of injury mechanism and utilize nonspecific terminology which thus diminish their clinical relevance add to the difficulty of educating doctors and performing prospective research.
QUESTIONS/PURPOSES: We characterized the potential benefits of the Subaxial Injury Classification (SLIC) scale which considers three major variables that influence spinal stability: morphology, integrity of the discoligamentous complex, and neurologic status. Each category was assigned a certain number of points based on the severity of the injury which are added together to generate a total score; this value provides prognostic information and may also be useful for directing subsequent management (ie, nonoperative treatment versus operative intervention).
METHODS: We examined the individual components that comprise the SLIC paradigm and reviewed the manner in which cervical injuries are scored and stratified. We also critically assessed the preliminary data comparing the SLIC scheme to preexisting classification systems.
RESULTS: The results of a preliminary analysis demonstrate that the intraclass coefficients (ICC) for the three primary components range between 0.49 and 0.90, suggesting that the overall reliability of the SLIC system appears to be at least as good as that of other conventional schemes for classifying subaxial cervical spine trauma (ICC between 0.41 and 0.53).
CONCLUSIONS: This scheme will hopefully facilitate the development of evidence-based guidelines that may influence other aspects of the therapeutic decision-making process (eg, which operative approach is most appropriate for a particular injury). We anticipate its accuracy and reproducibility will increase over time as surgeons become more familiar with the protocol.
Authors:
Peter G Whang; Alpesh A Patel; Alexander R Vaccaro
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Publication Detail:
Type:  Case Reports    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-03     Completed Date:  2011-03-24     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  723-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
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MeSH Terms
Descriptor/Qualifier:
Accidents
Adult
Cervical Vertebrae / injuries*,  pathology
Dislocations / classification*,  diagnosis
Female
Humans
Injury Severity Score*
Male
Middle Aged
Prognosis
Reproducibility of Results
Spinal Fractures / classification*,  diagnosis
Spinal Injuries / classification*,  diagnosis
Trauma, Nervous System / classification*,  diagnosis
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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