ArticleGlobal spine journal2024
A Practical Classification System for Acute Cervical Spinal Cord Injury Based on a Three-Phased Modified Delphi Process From the AOSpine Spinal Cord Injury Knowledge Forum.
Article in Global spine journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of anterior and posterior approach in the treatment of acute and chronic cervical spinal cord injury: a meta-analysis.Frontiers in surgery · 2024Pooled it
- Awake closed manual reduction of cervical spine dislocation as an emergency bridge to surgery: a case report.Frontiers in medicine · 2026Article
- Characteristics and Clinical Outcomes of Transition from Conservative Therapy to Surgical Intervention in Older Patients with Cervical Spinal Cord Injury without Major Bone Injury: A Nationwide Retrospective Study.Spine surgery and related research · 2025Article
- International Spinal Cord Injury Community Survey: Socioeconomic and Healthcare Satisfaction in Spain.Global spine journal · 2024Article
- Article
- Management of Cervical Spinal Cord Injury without Major Bone Injury in Adults.Journal of clinical medicine · 2023Review
- The Incidence, Characteristics and Outcomes of Vertebral Artery Injury Associated with Cervical Spine Trauma: A Systematic Review.Global spine journal · 2023Article
- Pathophysiology and surgical decision-making in central cord syndrome and degenerative cervical myelopathy: correcting the somatotopic fallacy.Frontiers in neurology · 2023Review
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designA modified Delphi study.
objectiveTo assess current practice patterns in the management of cervical spinal cord injury (SCI) and develop a simplified, practical classification system which offers ease of use in the acute setting, incorporates modern diagnostic tools and provides utility in determining treatment strategies for cervical SCI.
methodsA three-phase modified Delphi procedure was performed between April 2020 and December 2021. During the first phase, members of the AOSpine SCI Knowledge forum proposed variables of importance for classifying and treating cervical SCI. The second phase involved an international survey of spine surgeons gauging practices surrounding the role and timing of surgery for cervical SCI and opinions regarding factors which most influence these practices. For the third phase, information obtained from phases 1 and 2 were used to draft a new classification system.
results396 surgeons responded to the survey. Neurological status, spinal stability and cord compression were the most important variables influencing decisions surrounding the role and timing of surgery. The majority (>50%) of respondents preferred to perform surgery within 24 hours post-SCI in clinical scenarios in which there was instability, severe cord compression or severe neurology. Situations in which <50% of respondents were inclined to operate early included: SCI with mild neurological impairments, with cord compression but without instability (with or without medical comorbidities), and SCI without cord compression or instability.
conclusionsSpinal stability, cord compression and neurological status are the most important variables influencing surgeons' practices surrounding the surgical management of cervical SCI. Based on these results, a simplified classification system for acute cervical SCI has been proposed.
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