Management of Acute Subaxial Trauma and Spinal Cord Injury in Professional Collision Athletes.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Dr Schroeder has received funds to travel from AO Spine and Medtronic. Dr Vaccaro has consulted or has done independent contracting for DePuy, Medtronic, Stryker Spine, Globus, Stout Medical, Gerson Lehrman Group, Guidepoint Global, Medacorp, Innovative Surgical Design, Orthobullets, Ellipse, and Vertex. He has also served on the scientific advisory board/board of directors/committees for Flagship Surgical, AO Spine, Innovative Surgical Design, and Association of Collaborative Spine Research. Dr Vaccaro has received royalty payments from Medtronic, Stryker Spine, Globus, Aesculap, Thieme, Jaypee, Elsevier, and Taylor Francis/Hodder and Stoughton. He has stock/stock option ownership interests in Replication Medica, Globus, Paradigm Spine, Stout Medical, Progressive Spinal Technologies, Advanced Spinal Intellectual Properties, Spine Medica, Computational Biodynamics, Spinology, In Vivo, Flagship Surgical, Cytonics, Bonovo Orthopaedics, Electrocore, Gamma Spine, Location Based Intelligence, FlowPharma, R.S.I., Rothman Institute and Related Properties, Innovative Surgical Design, and Avaz Surgical. In addition, Dr Vaccaro has also provided expert testimony. He has also served as deputy editor/editor of Clinical Spine Surgery. The remaining authors declare no conflict of interest. 9. Spine (Phila Pa 1976). 2006 May 15;31(11 Suppl):S37-43; discussion S61. doi: 10.1097/01.brs.0000217942.93428.f7. Classification of lower cervical spine injuries. Moore TA(1), Vaccaro AR, Anderson PA. Author information: (1)MetroHealth Medical Center, Department of Orthopaedic Surgery, Cleveland, OH, USA. Comment in Spine (Phila Pa 1976). 2008 Sep 1;33(19):2124; author reply 2124-5. doi: 10.1097/BRS.0b013e31817e30e7. STUDY DESIGN: Blinded assessment by multiple observers of consecutive case series. OBJECTIVES: Measure the reliability of a new system of determining stability in subaxial cervical spine injuries. SUMMARY OF BACKGROUND DATA: Classification is fundamental to allow communication, determine prognosis, and direct treatment. Current systems have many limitations, including difficultly of use, lack of proven reliability and validity, and no assessment of stability. A new system to assess instability is proposed. METHODS: A literature review of the most commonly described classification systems is reported. The Cervical Spine Injury Severity Score was tested for reliability by 10 examiners who graded 35 consecutive cases of cervical trauma. Plain radiographs and CT were saved as read using Efilm Lite in random order. Each was scored and intraobserver and interobserver agreement was measured using intraclass correlation coefficients (ICC). RESULTS: Intraobserver agreement was excellent with ICC ranging from 0.97 to 0.99. Interobserver agreement was also excellent with mean 0.80 ranging from 0.75 to 0.98. CONCLUSION: A new cervical spine classification system of injury is paramount to treatment and outcomes. A new system may increase reliability and therefore allow more accurate determination of stability and dictate treatment. DOI: 10.1097/01.brs.0000217942.93428.f7