TY - JOUR
T1 - Subaxial cervical spine injury classification systems
AU - Aarabi, Bizhan
AU - Walters, Beverly C.
AU - Dhall, Sanjay S.
AU - Gelb, Daniel E.
AU - John Hurlbert, R.
AU - Rozzelle, Curtis J.
AU - Ryken, Timothy C.
AU - Theodore, Nicholas
AU - Hadley, Mark N.
PY - 2013/3
Y1 - 2013/3
N2 - The challenge confronting providers caring for patients with cervical spine traumatic injuries is how to quantify instability and create an algorithm of treatment in order to protect the spinal cord from further damage, prevent future spinal deformity and mitigate pain and discomfort. 7,38-40,54-61 Biomechanical, cadaveric, and autopsy studies have confirmed the importance of ligamentous integrity of anterior and posterior cervical spine elements for smooth, effortless movements of cervical spine under physiological loads.9,39-42,54 Due to the lack of appropriate sectional imaging, previous investigators have resorted to major injury vectors (MIV) in order to construct descriptive mechanical classification of cervical spine injuries.1-4,7,8,10,12,13,16,17,21-23,25,27,29,54,62-65 However, these systems are complicated and difficult to use; their clinical relevance is not intuitive. In addition, their reliability is low, and they probably do not add value to clinical research on spinal cord injury. The only suggestion might be to use the Harris classification system in addition to a more reliable classification for comparison with previously reported studies using this older scheme. Anatomical injury severity is one of the major independent variables that needs to be quantified for future therapeutic trials. Two partially validated classification systems, the SLIC and severity scale and the CSISS, have tried to scale and score injury severity, taking advantage of sectional imaging.35,37,38,59,60.
AB - The challenge confronting providers caring for patients with cervical spine traumatic injuries is how to quantify instability and create an algorithm of treatment in order to protect the spinal cord from further damage, prevent future spinal deformity and mitigate pain and discomfort. 7,38-40,54-61 Biomechanical, cadaveric, and autopsy studies have confirmed the importance of ligamentous integrity of anterior and posterior cervical spine elements for smooth, effortless movements of cervical spine under physiological loads.9,39-42,54 Due to the lack of appropriate sectional imaging, previous investigators have resorted to major injury vectors (MIV) in order to construct descriptive mechanical classification of cervical spine injuries.1-4,7,8,10,12,13,16,17,21-23,25,27,29,54,62-65 However, these systems are complicated and difficult to use; their clinical relevance is not intuitive. In addition, their reliability is low, and they probably do not add value to clinical research on spinal cord injury. The only suggestion might be to use the Harris classification system in addition to a more reliable classification for comparison with previously reported studies using this older scheme. Anatomical injury severity is one of the major independent variables that needs to be quantified for future therapeutic trials. Two partially validated classification systems, the SLIC and severity scale and the CSISS, have tried to scale and score injury severity, taking advantage of sectional imaging.35,37,38,59,60.
KW - Cervical spine trauma
KW - Radiographic classification
KW - Spinal cord injury
KW - Spinal fracture classification
KW - Spinal injury classification
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U2 - 10.1227/NEU.0b013e31828341c5
DO - 10.1227/NEU.0b013e31828341c5
M3 - Article
C2 - 23417189
AN - SCOPUS:84874392913
SN - 0148-396X
VL - 72
SP - 170
EP - 186
JO - Neurosurgery
JF - Neurosurgery
IS - SUPPL.2
ER -