AOSpine subaxial cervical spine injury classification system

Alexander R. Vaccaro*, John D. Koerner, Kris E. Radcliff, F. Cumhur Oner, Maximilian Reinhold, Klaus J. Schnake, Frank Kandziora, Michael G. Fehlings, Marcel F. Dvorak, Bizhan Aarabi, Shanmuganathan Rajasekaran, Gregory D. Schroeder, Christopher K. Kepler, Luiz R. Vialle

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: This project describes a morphology-based subaxial cervical spine traumatic injury classification system. Using the same approach as the thoracolumbar system, the goal was to develop a comprehensive yet simple classification system with high intra- and interobserver reliability to be used for clinical and research purposes. Methods: A subaxial cervical spine injury classification system was developed using a consensus process among clinical experts. All investigators were required to successfully grade 10 cases to demonstrate comprehension of the system before grading 30 additional cases on two occasions, 1 month apart. Kappa coefficients (κ) were calculated for intraobserver and interobserver reliability. Results: The classification system is based on three injury morphology types similar to the TL system: compression injuries (A), tension band injuries (B), and translational injuries (C), with additional descriptions for facet injuries, as well as patient-specific modifiers and neurologic status. Intraobserver and interobserver reliability was substantial for all injury subtypes (κ = 0.75 and 0.64, respectively). Conclusions: The AOSpine subaxial cervical spine injury classification system demonstrated substantial reliability in this initial assessment, and could be a valuable tool for communication, patient care and for research purposes.

Original languageEnglish
Pages (from-to)2173-2184
Number of pages12
JournalEuropean Spine Journal
Volume25
Issue number7
DOIs
Publication statusPublished - 1 Jul 2016

Keywords

  • AOSpine
  • Cervical
  • Classification
  • Injury
  • Spine
  • Subaxial
  • Trauma

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