Test: Subaxial Cervical Spine Injury Imaging - Morphollogy

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Background/Purpose

Subaxial cervical spine trauma is common and an often missed diagnosis. Accurate and efficient diagnosis and management is necessary to avoid devastating complications such as spinal cord injury. Several classification schemes have been devised to help categorize fractures of the subaxial spine and define treatment algorithms. The Subaxial Cervical Spine Injury Classification System (SLIC) is widely used and evaluates not only fracture morphology but also considers ligamentous injury and neurological status in surgical decision making. However, interobserver reliability is poor, which proves to be the defining pitfall of this tool. More modern classification systems have been developed, which aim to improve the interobserver reliability; however, further large-scale studies are needed for more definitive evaluation. Overall, treatment of subaxial cervical spine injuries should include a protocol with initial trauma evaluation, leading to expedient operative intervention if indicated. Surgical techniques include both anterior and posterior approaches to the cervical spine depending on fracture classification.

Procedure

Computed tomography (CT) scans have attained more widespread use to evaluate the cervical spine given their wide availability, rapid accessibility in the trauma bay, and robust image quality. CT scans also allow excellent visualization of the cervicothoracic and occipitocervical junctions, which are often of poor quality on plain films. Sensitivity of 99 % and specificity of 100 % have been demonstrated in some studies with use of multiplanar CT
Characteristic Points
No abnormality 0
Compression 1
Burst 1+1=2
Distraction (eg, facet perch, hyperextension) 3
Rotation/translation (eg, facet dislocation, unstable teardrop or advanced-stage flexion compression injury) 4

Performed: Bilaterally

Dialog

CT Imaging of cervical spine with SLIC grading.

Criteria

• Appropriate morphology of the cervical spine.

Measurement

0.00

LOINC Code

0

Scale/Grading

Pass/Fail