The classifications of subaxial cervical spine traumatic injuries. Part 4. AOSpine Subaxial Classification System

Cervical spine injuries are a fairly common consequence of mechanical impact on the human body. The subaxial level cervical accounts for approximately half to 2/3 these injuries. Despite numerous classification systems that exist describing injuries, recommendations treatment strategy very limited, and currently none them is universal generally accepted. Consequently, decisions based individual experience specialist, but not evidence or algorithms. While system mechanism trauma originally proposed by B.L. Allen et al. subsequently modified J.H. Harris Jr al., was comprehensive, lacked evidence, which some extent limited its clinical applicability. Similarly, Subaxial Injury Classification System Spine Trauma Group, had no distinct clinically significant patterns morphological damage. This fact hindered standardization unification tactical approaches. As an attempt solve this problem, in 2016 Alexander Vaccaro, together with AO Spine, injury system, using principle already existing AOSpine thoracolumbar aim project develop effective provides clear, relevant descriptions patterns, should contribute determination strategy. at follows same hierarchical approach as previous classifications, namely, it characterizes 4 parameters: (1) morphology, (2) facet damage, (3) neurological status, (4) specific modifiers. morphology divided into 3 subgroups injuries: A (compression), B (flexion-distraction), C (dislocations displacements). Damage types 5 (A0-A4) (B1-B3) subtypes, respectively. When damage joints, subtypes distinguished: F1 (fracture without displacement), F2 (unstable fracture), F3 (floating lateral mass) F4 (dislocation). also integrates assessment 6 subtype). In addition, includes modifiers designed better detail number pathological conditions. performance evaluation SCICS showed moderate range consistency reproducibility. Currently, quantitative scale assessing severity classes has been proposed, also, certain extent, contributes decision-making regarding