title: AOSpine subaxial cervical spine injury classification system.
abstract: This project describes a morphology-based subaxial cervical spine traumatic injury classification system. Using the same approach as the thoracolumbar system, the goal was to develop a comprehensive yet simple classification system with high intra- and interobserver reliability to be used for clinical and research purposes.
  
  
  
  A subaxial cervical spine injury classification system was developed using a consensus process among clinical experts. All investigators were required to successfully grade 10 cases to demonstrate comprehension of the system before grading 30 additional cases on two occasions, 1 month apart. Kappa coefficients (κ) were calculated for intraobserver and interobserver reliability.
  
  
  
  The classification system is based on three injury morphology types similar to the TL system: compression injuries (A), tension band injuries (B), and translational injuries (C), with additional descriptions for facet injuries, as well as patient-specific modifiers and neurologic status. Intraobserver and interobserver reliability was substantial for all injury subtypes (κ = 0.75 and 0.64, respectively).
  
  
  
  The AOSpine subaxial cervical spine injury classification system demonstrated substantial reliability in this initial assessment, and could be a valuable tool for communication, patient care and for research purposes.
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA. alexvaccaro3@aol.com.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Koerner
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Kris E
authors.initials: KE
authors.lastname: Radcliff
authors.affiliation: University Medical Center, Utrecht, The Netherlands.
authors.forename: F Cumhur
authors.initials: FC
authors.lastname: Oner
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Klinikum Suedstadt Rostock, Suedring 81, 18059, Rostock, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reinhold
authors.affiliation: Schön Klinik Nürnberg Fürth, Center for Spinal Surgery, Fürth, Germany.
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Schnake
authors.affiliation: Berufsgenossenschaftliche Unfallklinik Frankfurt, Center for Spinal Surgery and Neurotraumatology, Frankfurt, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Kandziora
authors.affiliation: University of Toronto Spine Program and Toronto Western Hospital, Toronto, ON, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.affiliation: University of British Columbia, Vancouver, BC, Canada.
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Dvorak
authors.affiliation: University of Maryland Medical Center, College Park, MD, USA.
authors.forename: Bizhan
authors.initials: B
authors.lastname: Aarabi
authors.affiliation: Ganga Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Shanmuganathan
authors.initials: S
authors.lastname: Rajasekaran
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Schroeder
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kepler
authors.affiliation: Catholic University of Parana, Curitiba, Brazil.
authors.forename: Luiz R
authors.initials: LR
authors.lastname: Vialle
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D032921:Consensus; D006801:Humans; D008279:Magnetic Resonance Imaging; D019838:Neck Injuries / Q000145:classification / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000145:classification* / Q000000981:diagnostic imaging; D016103:Spinal Fractures / Q000145:classification* / Q000000981:diagnostic imaging; D013124:Spinal Injuries / Q000145:classification / Q000000981:diagnostic imaging
keywords: AOSpine; Cervical; Classification; Injury; Spine; Subaxial; Trauma