The Subaxial Cervical AO Spine Injury Score

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.

[1]  J. Chapman,et al.  Establishing the Injury Severity of Subaxial Cervical Spine Trauma , 2020, Spine.

[2]  J. Chapman,et al.  AOSpine—Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles , 2019, Global spine journal.

[3]  K. Rijkers,et al.  Two-Nation Comparison of Classification and Treatment of Subaxial Cervical Spine Fractures: An Internet-Based Multicenter Study Among Spine Surgeons. , 2019, World neurosurgery.

[4]  M. Reinhold,et al.  Treatment of Injuries to the Subaxial Cervical Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) , 2018, Global spine journal.

[5]  E. Kasper,et al.  Posterior Rigid Instrumentation of C7: Surgical Considerations and Biomechanics at the Cervicothoracic Junction. A Review of the Literature. , 2017, World neurosurgery.

[6]  A. Vaccaro,et al.  AOSpine Classification Systems (Subaxial, Thoracolumbar) , 2017, Journal of orthopaedic trauma.

[7]  M. Campos,et al.  An Independent Inter- and Intraobserver Agreement Evaluation of the AOSpine Subaxial Cervical Spine Injury Classification System , 2017, Spine.

[8]  J. Buchowski,et al.  CERVICAL INJURIES AND TREATMENT ( HJ KIM , SECTION EDITOR ) Subaxial cervical spine trauma , 2016 .

[9]  Alpesh A. Patel,et al.  Evaluation of the reliability and validity of the newer AOSpine subaxial cervical injury classification (C-3 to C-7). , 2016, Journal of neurosurgery. Spine.

[10]  B. Aarabi,et al.  Reliability analysis of the AOSpine thoracolumbar spine injury classification system by a worldwide group of naïve spinal surgeons , 2016, European Spine Journal.

[11]  M. Campos,et al.  A comparative agreement evaluation of two subaxial cervical spine injury classification systems: the AOSpine and the Allen and Ferguson schemes , 2016, European Spine Journal.

[12]  B. Aarabi,et al.  The Thoracolumbar AOSpine Injury Score , 2015, Global spine journal.

[13]  Alexander R. Vaccaro,et al.  AOSpine subaxial cervical spine injury classification system , 2015, European Spine Journal.

[14]  C. Bolger,et al.  The Subaxial Cervical Spine Injury Classification System: an external agreement validation study. , 2013, The spine journal : official journal of the North American Spine Society.

[15]  L. Audigé,et al.  AO spine injury classification system: a revision proposal for the thoracic and lumbar spine , 2013, European Spine Journal.

[16]  Alpesh A. Patel,et al.  The Development and Evaluation of the Subaxial Injury Classification Scoring System for Cervical Spine Trauma , 2011, Clinical orthopaedics and related research.

[17]  P. Anderson,et al.  Reliability of classification systems for subaxial cervical injuries , 2010, Evidence-based spine-care journal.

[18]  D. Brodke,et al.  Thoracolumbar spine trauma classification: the Thoracolumbar Injury Classification and Severity Score system and case examples. , 2009, Journal of neurosurgery. Spine.

[19]  N. Haas,et al.  Typ-B-Distraktionsverletzungen der thorakolumbalen Wirbelsäule , 2008, Der Unfallchirurg.

[20]  T. Albert,et al.  Use of Computed Tomography to Predict Failure of Nonoperative Treatment of Unilateral Facet Fractures of the Cervical Spine , 2006, Spine.

[21]  J. Grauer,et al.  Subaxial cervical spine trauma. , 2006 .

[22]  B. Allen,et al.  A Mechanistic Classification of Closed, Indirect Fractures and Dislocations of the Lower Cervical Spine , 1982, Spine.

[23]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[24]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[25]  Clinical Biomechanics Of The Spine 2nd Edition , 2021 .

[26]  J. Harris,et al.  A practical classification of acute cervical spine injuries. , 1986, The Orthopedic clinics of North America.

[27]  Rating the severity of tissue damage. II. The comprehensive scale. , 1972, JAMA.