title: An evidence-based approach towards the cranio-cervical junction injury classifications.
abstract: OBJECTIVE
  The cranio-cervical junction (CCJ) is an anatomically, functionally and biomechanically complex region. It is commonly involved in trauma of varying severity that can be managed with a multitude of treatment options and carry diverse prognosis. Our objective is to evaluate the quality of currently used CCJ injury classifications in an evidence-based approach.
  
  
  METHODS
  We performed two consecutive literature reviews. In the first, we tried to find which classifications are currently used in CCJ injuries. In the second, we scrutinized the gathered classifications in terms of validity, reliability, severity grading, treatment guidance and prognosis assessment.
  
  
  RESULTS
  Twenty classifications are currently used to describe the CCJ injuries and 72 individual injury patterns have been recognized. Almost a third of them can grade severity, guide treatment and assess prognosis. Only two classifications have been tested for validity and reliability.
  
  
  CONCLUSIONS
  CCJ injuries are poorly described by the current classifications according to evidence-based criteria. There is an obvious need for a simple and reliable classification tool to guide patient management in the evidence-based medicine era.
authors: Department of Neurosurgery, University Hospital of Larissa, Biopolis, 41110, Larissa, Greece, alexgbrodis@yahoo.com.
authors: Alexandros G
authors: AG
authors: Brotis
authors: Tsiamalou M
authors: TM
authors: Paraskevi
authors: Parmenion
authors: P
authors: Tsitsopoulos
authors: Anastasia
authors: A
authors: Tasiou
authors: Georgios
authors: G
authors: Fotakopoulos
authors: Kostas N
authors: KN
authors: Fountas
mesh_terms: D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D015601:Injury Severity Score; D011379:Prognosis; D015203:Reproducibility of Results; D020196:Trauma, Nervous System / Q000175:diagnosis*