Cargando…

Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making

BACKGROUND AND AIM: Considering the high rate of mortality and permanent disability related to vertebral traumas, an early and detailed diagnosis of the trauma and subsequently an immediate and effective intervention are crucial. Cervical vertebral injury classifications guide treatment choice throu...

Descripción completa

Detalles Bibliográficos
Autores principales: Pagliei, Valeria, Bruno, Federico, Battista, Giuseppe, Iacopino, Antonio, Riva, Camilla, Arrigoni, Francesco, Palumbo, Pierpaolo, Bardi, Luca, Carbone, Mattia, Di Cesare, Ernesto, Masciocchi, Carlo, Splendiani, Alessandra, Barile, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477063/
https://www.ncbi.nlm.nih.gov/pubmed/34505843
http://dx.doi.org/10.23750/abm.v92iS5.11877
_version_ 1784575763338493952
author Pagliei, Valeria
Bruno, Federico
Battista, Giuseppe
Iacopino, Antonio
Riva, Camilla
Arrigoni, Francesco
Palumbo, Pierpaolo
Bardi, Luca
Carbone, Mattia
Di Cesare, Ernesto
Masciocchi, Carlo
Splendiani, Alessandra
Barile, Antonio
author_facet Pagliei, Valeria
Bruno, Federico
Battista, Giuseppe
Iacopino, Antonio
Riva, Camilla
Arrigoni, Francesco
Palumbo, Pierpaolo
Bardi, Luca
Carbone, Mattia
Di Cesare, Ernesto
Masciocchi, Carlo
Splendiani, Alessandra
Barile, Antonio
author_sort Pagliei, Valeria
collection PubMed
description BACKGROUND AND AIM: Considering the high rate of mortality and permanent disability related to vertebral traumas, an early and detailed diagnosis of the trauma and subsequently an immediate and effective intervention are crucial. Cervical vertebral injury classifications guide treatment choice through a severity grade based on radiological information. The purpose of the present study was to define which imaging classification system could provide the best morphological and clinical-surgical correlations for cervical spine traumas. METHODS: We retrospectively analyzed patients evaluated for cervical spine trauma at our Institution in the period 2015-2020. Information regarding the morphological examination (using CT and MRI), the neurological evaluation, and the therapeutic management were collected. C3-C7 fractures were classified according to the SLIC and AOSpine criteria; axial lesions were classified according to the modified AOSpine for the C1-C2 compartment and through the Roy-Camille and the Anderson D’Alonzo system for the odontoid process of the axis. RESULTS: 29 patients were included in the final study population. Nine patients with axial spine trauma and 21 with subaxial cervical spine trauma. A conservative approach was applied in 16 patients while nine patients underwent neurosurgery. Considering the therapeutical indications provided by the SLIC system, a 76.9% accordance was found for patients with a <4 score, while a 100% concordance was calculated for patients with a >4 score undergoing neurosurgery. Regarding the AOSspine classification, a 28.6% concordance was observed for patients classified group B being treated with a posterior neurosurgical approach, while for patients belonging to subgroup C, considered for anterior neurosurgical approach, a 66.7% accordance was calculated. CONCLUSIONS: The study demonstrated a better morphological correlation for the AOSpine classification in subaxial trauma and the AOSpine and Anderson D’Alonzo in axial trauma. The therapeutic indication found a better correlation in the SLIC classification for subaxial trauma and the Anderson D’Alonzo for axial ones. (www.actabiomedica.it)
format Online
Article
Text
id pubmed-8477063
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Mattioli 1885
record_format MEDLINE/PubMed
spelling pubmed-84770632021-10-08 Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making Pagliei, Valeria Bruno, Federico Battista, Giuseppe Iacopino, Antonio Riva, Camilla Arrigoni, Francesco Palumbo, Pierpaolo Bardi, Luca Carbone, Mattia Di Cesare, Ernesto Masciocchi, Carlo Splendiani, Alessandra Barile, Antonio Acta Biomed Original Article BACKGROUND AND AIM: Considering the high rate of mortality and permanent disability related to vertebral traumas, an early and detailed diagnosis of the trauma and subsequently an immediate and effective intervention are crucial. Cervical vertebral injury classifications guide treatment choice through a severity grade based on radiological information. The purpose of the present study was to define which imaging classification system could provide the best morphological and clinical-surgical correlations for cervical spine traumas. METHODS: We retrospectively analyzed patients evaluated for cervical spine trauma at our Institution in the period 2015-2020. Information regarding the morphological examination (using CT and MRI), the neurological evaluation, and the therapeutic management were collected. C3-C7 fractures were classified according to the SLIC and AOSpine criteria; axial lesions were classified according to the modified AOSpine for the C1-C2 compartment and through the Roy-Camille and the Anderson D’Alonzo system for the odontoid process of the axis. RESULTS: 29 patients were included in the final study population. Nine patients with axial spine trauma and 21 with subaxial cervical spine trauma. A conservative approach was applied in 16 patients while nine patients underwent neurosurgery. Considering the therapeutical indications provided by the SLIC system, a 76.9% accordance was found for patients with a <4 score, while a 100% concordance was calculated for patients with a >4 score undergoing neurosurgery. Regarding the AOSspine classification, a 28.6% concordance was observed for patients classified group B being treated with a posterior neurosurgical approach, while for patients belonging to subgroup C, considered for anterior neurosurgical approach, a 66.7% accordance was calculated. CONCLUSIONS: The study demonstrated a better morphological correlation for the AOSpine classification in subaxial trauma and the AOSpine and Anderson D’Alonzo in axial trauma. The therapeutic indication found a better correlation in the SLIC classification for subaxial trauma and the Anderson D’Alonzo for axial ones. (www.actabiomedica.it) Mattioli 1885 2021 2021-09-10 /pmc/articles/PMC8477063/ /pubmed/34505843 http://dx.doi.org/10.23750/abm.v92iS5.11877 Text en Copyright: © 2021 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA https://creativecommons.org/licenses/by-nc-sa/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License
spellingShingle Original Article
Pagliei, Valeria
Bruno, Federico
Battista, Giuseppe
Iacopino, Antonio
Riva, Camilla
Arrigoni, Francesco
Palumbo, Pierpaolo
Bardi, Luca
Carbone, Mattia
Di Cesare, Ernesto
Masciocchi, Carlo
Splendiani, Alessandra
Barile, Antonio
Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
title Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
title_full Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
title_fullStr Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
title_full_unstemmed Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
title_short Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
title_sort cervical spine trauma: impact of different imaging classification systems in the clinical decision-making
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477063/
https://www.ncbi.nlm.nih.gov/pubmed/34505843
http://dx.doi.org/10.23750/abm.v92iS5.11877
work_keys_str_mv AT paglieivaleria cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT brunofederico cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT battistagiuseppe cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT iacopinoantonio cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT rivacamilla cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT arrigonifrancesco cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT palumbopierpaolo cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT bardiluca cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT carbonemattia cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT dicesareernesto cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT masciocchicarlo cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT splendianialessandra cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking
AT barileantonio cervicalspinetraumaimpactofdifferentimagingclassificationsystemsintheclinicaldecisionmaking