title: Reliability and safety of a new upper cervical spine injury treatment algorithm.
abstract: METHODS
  Thirty cases, previously treated according to the new algorithm, were presented to four spine surgeons who were questioned about their personal suggestion for treatment, and the treatment suggested according to the application of the algorithm. After four weeks, the same questions were asked again to evaluate reliability (intra- and inter-observer) using the Kappa index.
  
  
  RESULTS
  The reliability of the treatment suggested by applying the algorithm was superior to the reliability of the surgeons' personal suggestion for treatment. When applying the upper cervical spine injury treatment algorithm, an agreement with the treatment actually performed was obtained in more than 89% of the cases.
  
  
  CONCLUSIONS
  The system is safe and reliable for treating traumatic upper cervical spine injuries. The algorithm can be used to help surgeons in the decision between conservative versus surgical treatment of these injuries.
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.|Universidade Estadual de Campinas, Divisão de Neurocirurgia, Campinas SP, Brasil.
authors.forename: Andrei Fernandes
authors.initials: AF
authors.lastname: Joaquim
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Roger Schmidt
authors.initials: RS
authors.lastname: Brock
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Vinicius Monteiro de Paula
authors.initials: VM
authors.lastname: Guirado
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Luis Henrique
authors.initials: LH
authors.lastname: Sandon
authors.affiliation: Universidade Estadual de Campinas, Divisão de Neurocirurgia, Campinas SP, Brasil.
authors.forename: Otávio Turolo da
authors.initials: OT
authors.lastname: Silva
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Mário Augusto
authors.initials: MA
authors.lastname: Taricco
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Universidade de São Paulo, Divisão de Neurocirurgia, São Paulo SP, Brasil.
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D015588:Observer Variation; D015203:Reproducibility of Results; D013124:Spinal Injuries / Q000145:classification / Q000601:surgery*; D055815:Young Adult