Subaxial cervical spine trauma classification: the subaxial injury classification system and case examples

Object. The authors review a novel subaxial cervical trauma classification system and demonstrate its application through a series of cervical trauma cases. Methods. The Spine Trauma Study Group collaborated to create the Subaxial Injury Classification (SLIC) and Severity score. The SLIC system is reviewed and is applied to 3 cases of subaxial cervical trauma. Results. The SLIC system identifies 3 major injury characteristics to describe subaxial cervical injuries: injury morphology, discoligamentous complex integrity, and neurological status. Minor injury characteristics include injury level and osseous fractures. Each major characteristic is assigned a numerical score based upon injury severity. The sum of these scores constitutes the injury severity score. Conclusions. By addressing both discoligamentous integrity and neurological status, the SLIC system may overcome major limitations of earlier classification systems. The system incorporates a number of critical clinical variables-including neurological status, absent in earlier systems-and is simple to apply and may provide both diagnostic and prognostic information.