Subaxial Cervical Spine Injury Classification Systems
Publication Date: March 1, 2013
Last Updated: March 14, 2022
RECOMMENDATIONS
Level I
The Subaxial Injury Classification (SLIC) and severity scale is recommended as a classification system for spinal cord injury. This system includes morphological, ligamentous, and neurological information in its scoring, thus communicating a greater amount of information regarding the extent of the patient’s injury. Its overall inter-rater reliability has an intraclass correlation coefficient of 0.71.
6731
The Cervical Spine Injury Severity Score (CSISS) is recommended as a classification system for graded instability and fracture patterns in patients with spinal cord injury. Although there is excellent reliability, (intraobserver and interobserver intraclass correlation coefficients for 15 reviewers were 0.977 and 0.883, respectively) the system is somewhat complicated, and its use may be limited to clinical trials rather than daily practice.
6731
Level III
The Harris classification of subaxial spinal injury is not recommended for describing the bony and soft tissue characteristics seen on imaging studies in spinal cord injury due to its low reliability (intraclass correlation coefficient of 0.42). It may be used in addition to more reliable measures for comparison to previous or other studies using this system.
6731
The Allen classification of subaxial spinal injury is not recommended for describing the mechanistic and imaging findings in cervical spine and spinal cord injury due to its low reliability (intraclass correlation coefficient of 0.53). Fortunately, this classification system is not in widespread use.
6731
Recommendation Grading
Overview
Title
Subaxial Cervical Spine Injury Classification Systems
Authoring Organization
Congress of Neurological Surgeons
Publication Month/Year
March 1, 2013
Last Updated Month/Year
January 10, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory, Childcare center, Hospital, Operating and recovery room
Intended Users
Physician, chiropractor, nurse, nurse practitioner, physician assistant
Scope
Assessment and screening, Diagnosis, Management, Treatment
Diseases/Conditions (MeSH)
D013131 - Spine, D016103 - Spinal Fractures
Keywords
spinal cord injury, Cervical spine trauma, Radiographic classification, Subaxial Cervical, Spinal fracture classification, Spinal injury classification