Subaxial injury classification scoring system treatment recommendations: external agreement study based on retrospective review of 185 patients
Retrospective case series. To test validity of subaxial injury classification (SLIC) treatment recommendations. Although SLIC has been tested for reliability, external studies that test the validity of its treatment recommendations are lacking. The SLIC score was determined by reviewing imaging stud...
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| Veröffentlicht in: | Spine (Philadelphia, Pa. 1976) Pa. 1976), 2015-02, Vol.40 (3), p.137-142 |
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| container_title | Spine (Philadelphia, Pa. 1976) |
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| creator | Samuel, Sumant Lin, Jiun-Lih Smith, Margaret M Hartin, Nathan L Vasili, Con Ruff, Stephen J Cree, Andrew K Ball, Jonathan R Sergides, Ioannis G Gray, Randolph |
| description | Retrospective case series.
To test validity of subaxial injury classification (SLIC) treatment recommendations.
Although SLIC has been tested for reliability, external studies that test the validity of its treatment recommendations are lacking.
The SLIC score was determined by reviewing imaging studies and clinical records in a consecutive series of 185 patients with subaxial cervical spine trauma presenting to a level 1 spinal injury referral center. Details including attending surgeon responsible for treatment decision, treatment received, and surgical approach were collected.
Treatment received matched SLIC guidelines in 93.6% nonsurgically managed patients and 96.3% surgically managed patients. The mean SLIC score of the surgically treated group of patients was significantly higher than that of the nonsurgical group (7.14 vs. 2.22; P |
| doi_str_mv | 10.1097/BRS.0000000000000666 |
| format | Article |
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To test validity of subaxial injury classification (SLIC) treatment recommendations.
Although SLIC has been tested for reliability, external studies that test the validity of its treatment recommendations are lacking.
The SLIC score was determined by reviewing imaging studies and clinical records in a consecutive series of 185 patients with subaxial cervical spine trauma presenting to a level 1 spinal injury referral center. Details including attending surgeon responsible for treatment decision, treatment received, and surgical approach were collected.
Treatment received matched SLIC guidelines in 93.6% nonsurgically managed patients and 96.3% surgically managed patients. The mean SLIC score of the surgically treated group of patients was significantly higher than that of the nonsurgical group (7.14 vs. 2.22; P<0.001). Sixty-six patients had a SLIC score of 3 or less, and 94% of them were nonsurgically managed (P<0.001). One hundred two patients had a SLIC score of 5 or more, and 95% of them were surgically managed (P<0.001). Seventeen patients had a SLIC score of 4, and 65% were nonsurgically managed (P=0.032). Injury morphology scores were not predictive of surgical approach. Increasing SLIC scores correlated with increasing complexity of treatment (r=0.77; P<0.001). The distribution of patients with regard to severity of injuries and treatment delivered by the 7 spinal surgeons was comparable. The past practice of these 7 fellowship-trained spine surgeons was individually in agreement with SLIC treatment recommendations.
Our past practice reflects SLIC treatment recommendations for nonsurgical treatment of patients with SLIC scores of 3 or less and surgical treatment of patients with SLIC scores of 5 or more. The use of SLIC as an ordinal severity scale is validated as increasing SLIC scores correlated with increasing complexity of treatment. The injury morphology score did not predict a surgical approach. Significantly higher numbers of patients with a SLIC score of 4 were treated nonsurgically.
3.</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0000000000000666</identifier><identifier>PMID: 25341989</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Cervical Vertebrae - surgery ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Spinal Injuries - diagnosis ; Spinal Injuries - surgery ; Young Adult</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2015-02, Vol.40 (3), p.137-142</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c171t-39d5b8657f82916fa76d4d159c80237e260dadb22b7a69b9665349ffbf2aeaff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25341989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samuel, Sumant</creatorcontrib><creatorcontrib>Lin, Jiun-Lih</creatorcontrib><creatorcontrib>Smith, Margaret M</creatorcontrib><creatorcontrib>Hartin, Nathan L</creatorcontrib><creatorcontrib>Vasili, Con</creatorcontrib><creatorcontrib>Ruff, Stephen J</creatorcontrib><creatorcontrib>Cree, Andrew K</creatorcontrib><creatorcontrib>Ball, Jonathan R</creatorcontrib><creatorcontrib>Sergides, Ioannis G</creatorcontrib><creatorcontrib>Gray, Randolph</creatorcontrib><title>Subaxial injury classification scoring system treatment recommendations: external agreement study based on retrospective review of 185 patients</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>Retrospective case series.
To test validity of subaxial injury classification (SLIC) treatment recommendations.
Although SLIC has been tested for reliability, external studies that test the validity of its treatment recommendations are lacking.
The SLIC score was determined by reviewing imaging studies and clinical records in a consecutive series of 185 patients with subaxial cervical spine trauma presenting to a level 1 spinal injury referral center. Details including attending surgeon responsible for treatment decision, treatment received, and surgical approach were collected.
Treatment received matched SLIC guidelines in 93.6% nonsurgically managed patients and 96.3% surgically managed patients. The mean SLIC score of the surgically treated group of patients was significantly higher than that of the nonsurgical group (7.14 vs. 2.22; P<0.001). Sixty-six patients had a SLIC score of 3 or less, and 94% of them were nonsurgically managed (P<0.001). One hundred two patients had a SLIC score of 5 or more, and 95% of them were surgically managed (P<0.001). Seventeen patients had a SLIC score of 4, and 65% were nonsurgically managed (P=0.032). Injury morphology scores were not predictive of surgical approach. Increasing SLIC scores correlated with increasing complexity of treatment (r=0.77; P<0.001). The distribution of patients with regard to severity of injuries and treatment delivered by the 7 spinal surgeons was comparable. The past practice of these 7 fellowship-trained spine surgeons was individually in agreement with SLIC treatment recommendations.
Our past practice reflects SLIC treatment recommendations for nonsurgical treatment of patients with SLIC scores of 3 or less and surgical treatment of patients with SLIC scores of 5 or more. The use of SLIC as an ordinal severity scale is validated as increasing SLIC scores correlated with increasing complexity of treatment. The injury morphology score did not predict a surgical approach. Significantly higher numbers of patients with a SLIC score of 4 were treated nonsurgically.
3.</description><subject>Adult</subject><subject>Aged</subject><subject>Cervical Vertebrae - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Spinal Injuries - diagnosis</subject><subject>Spinal Injuries - surgery</subject><subject>Young Adult</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkclqHDEQhoWJscfLG4SgYy490dKtbuWWGNsJGAxezo1aKg0aepmo1PbMU_iVLS8JwbqUBN__l6p-Qj5ztuRM199-3twu2f9HKbVHFrwSTcF5pT-RBZNKFKKU6pAcIa5fGMn1ATkUlSy5bvSCPN3OndkG09Mwrue4o7Y3iMEHa1KYRop2imFcUdxhgoGmCCYNMCYawU5DvrlXDr9T2CaIYzYyqwjwymCa3Y52BsHR7BUhxQk3YFN4gPx6CPBIJ095U9FNtskSPCH73vQIp-_1mNxfnN-d_Squri9_n_24KiyveSqkdlXXqKr2jdBceVMrV7o8tW2YkDUIxZxxnRBdbZTutFJ5Yu1954UB4708Jl_ffDdx-jMDpnYIaKHvzQjTjC1XVVkzKVid0fINtfn3GMG3mxgGE3ctZ-1LFG2Oov0YRZZ9ee8wdwO4f6K_u5fP9ziIWQ</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Samuel, Sumant</creator><creator>Lin, Jiun-Lih</creator><creator>Smith, Margaret M</creator><creator>Hartin, Nathan L</creator><creator>Vasili, Con</creator><creator>Ruff, Stephen J</creator><creator>Cree, Andrew K</creator><creator>Ball, Jonathan R</creator><creator>Sergides, Ioannis G</creator><creator>Gray, Randolph</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>Subaxial injury classification scoring system treatment recommendations: external agreement study based on retrospective review of 185 patients</title><author>Samuel, Sumant ; Lin, Jiun-Lih ; Smith, Margaret M ; Hartin, Nathan L ; Vasili, Con ; Ruff, Stephen J ; Cree, Andrew K ; Ball, Jonathan R ; Sergides, Ioannis G ; Gray, Randolph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c171t-39d5b8657f82916fa76d4d159c80237e260dadb22b7a69b9665349ffbf2aeaff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cervical Vertebrae - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Spinal Injuries - diagnosis</topic><topic>Spinal Injuries - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samuel, Sumant</creatorcontrib><creatorcontrib>Lin, Jiun-Lih</creatorcontrib><creatorcontrib>Smith, Margaret M</creatorcontrib><creatorcontrib>Hartin, Nathan L</creatorcontrib><creatorcontrib>Vasili, Con</creatorcontrib><creatorcontrib>Ruff, Stephen J</creatorcontrib><creatorcontrib>Cree, Andrew K</creatorcontrib><creatorcontrib>Ball, Jonathan R</creatorcontrib><creatorcontrib>Sergides, Ioannis G</creatorcontrib><creatorcontrib>Gray, Randolph</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samuel, Sumant</au><au>Lin, Jiun-Lih</au><au>Smith, Margaret M</au><au>Hartin, Nathan L</au><au>Vasili, Con</au><au>Ruff, Stephen J</au><au>Cree, Andrew K</au><au>Ball, Jonathan R</au><au>Sergides, Ioannis G</au><au>Gray, Randolph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subaxial injury classification scoring system treatment recommendations: external agreement study based on retrospective review of 185 patients</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>40</volume><issue>3</issue><spage>137</spage><epage>142</epage><pages>137-142</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><abstract>Retrospective case series.
To test validity of subaxial injury classification (SLIC) treatment recommendations.
Although SLIC has been tested for reliability, external studies that test the validity of its treatment recommendations are lacking.
The SLIC score was determined by reviewing imaging studies and clinical records in a consecutive series of 185 patients with subaxial cervical spine trauma presenting to a level 1 spinal injury referral center. Details including attending surgeon responsible for treatment decision, treatment received, and surgical approach were collected.
Treatment received matched SLIC guidelines in 93.6% nonsurgically managed patients and 96.3% surgically managed patients. The mean SLIC score of the surgically treated group of patients was significantly higher than that of the nonsurgical group (7.14 vs. 2.22; P<0.001). Sixty-six patients had a SLIC score of 3 or less, and 94% of them were nonsurgically managed (P<0.001). One hundred two patients had a SLIC score of 5 or more, and 95% of them were surgically managed (P<0.001). Seventeen patients had a SLIC score of 4, and 65% were nonsurgically managed (P=0.032). Injury morphology scores were not predictive of surgical approach. Increasing SLIC scores correlated with increasing complexity of treatment (r=0.77; P<0.001). The distribution of patients with regard to severity of injuries and treatment delivered by the 7 spinal surgeons was comparable. The past practice of these 7 fellowship-trained spine surgeons was individually in agreement with SLIC treatment recommendations.
Our past practice reflects SLIC treatment recommendations for nonsurgical treatment of patients with SLIC scores of 3 or less and surgical treatment of patients with SLIC scores of 5 or more. The use of SLIC as an ordinal severity scale is validated as increasing SLIC scores correlated with increasing complexity of treatment. The injury morphology score did not predict a surgical approach. Significantly higher numbers of patients with a SLIC score of 4 were treated nonsurgically.
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Cervical Vertebrae - surgery Female Humans Injury Severity Score Male Middle Aged Reproducibility of Results Retrospective Studies Spinal Injuries - diagnosis Spinal Injuries - surgery Young Adult |
| title | Subaxial injury classification scoring system treatment recommendations: external agreement study based on retrospective review of 185 patients |
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