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New System to Classify Neck Injuries

Managing severe cervical spine (neck) injuries can be improved with a reliable classification system. Such a system would help doctors describe the injury, plan treatment, and predict the outcome. Should the patient have surgery? Are neurologic problems likely? What's the prognosis?

In this study, a new classification system is presented based on morphology and stability. Morphology refers to form and structure. In the case of cervical spine injuries location and type of injury are described as part of the morphology.

For example anterior or front of the spine injuries include fractures, disc herniations, or disc distraction. Lateral or side of the spine injuries affect the joints called facets. The joints can be fractured or dislocated. The discs may be distracted or herniated to the front, side, or back. Posterior or back of the spine can include bone fractures and trauma to the disc, but also damage to the ligaments.

In order to measure stability after cervical spine trauma, a special tool was developed called the Cervical Spine Injury Severity Score. The score reflects bone and ligament injury. It doesn't include neurologic function. Each column or side of the spine is scored separately. Then each column is added together for a total sum to describe stability. The more severe the injury, the less stable the spine is.

The authors say the tool is easy to learn, reliable, and can be used with all types of fractures. It can be used in many different settings such as the emergency room, research lab, or during the healing process.

References: Timothy A. Moore, MD, et al. Classification of Lower Cervical Spine Injuries. In Spine. May 15, 2006. Vol. 31. No. 11S. Pp. S37-S43.

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