Variation in global treatment for subaxial cervical spine isolated unilateral facet fractures.

Karamian, Brian A; Schroeder, Gregory D; Holas, Martin; Joaquim, Andrei F; Canseco, Jose A; Rajasekaran, Shanmuganathan; Benneker, Lorin M; Kandziora, Frank; Schnake, Klaus J; Öner, F Cumhur; Kepler, Christopher K; Vaccaro, Alexander R (2021). Variation in global treatment for subaxial cervical spine isolated unilateral facet fractures. European spine journal, 30(6), pp. 1635-1650. Springer 10.1007/s00586-021-06818-z

[img]
Preview
Text
Karamian2021_Article_VariationInGlobalTreatmentForS.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (725kB) | Preview

PURPOSE

To determine the variation in the global treatment practices for subaxial unilateral cervical spine facet fractures based on surgeon experience, practice setting, and surgical subspecialty.

METHODS

A survey was sent to 272 members of the AO Spine Subaxial Injury Classification System Validation Group worldwide. Questions surveyed surgeon preferences with regard to diagnostic work-up and treatment of fracture types F1-F3, according to the AO Spine Subaxial Cervical Spine Injury Classification System, with various associated neurologic injuries.

RESULTS

A total of 161 responses were received. Academic surgeons use the facet portion of the AO Spine classification system less frequently (61.6%) compared to hospital-employed and private practice surgeons (81.1% and 81.8%, respectively) (p = 0.029). The overall consensus was in favor of operative treatment for any facet fracture with radicular symptoms (N2) and for any fractures categorized as F2N2 and above. For F3N0 fractures, significantly less surgeons from Africa/Asia/Middle East (49%) and Europe (59.2%) chose operative treatment than from North/Latin/South America (74.1%) (p = 0.025). For F3N1 fractures, significantly less surgeons from Africa/Asia/Middle East (52%) and Europe (63.3%) recommended operative treatment than from North/Latin/South America (84.5%) (p = 0.001). More than 95% of surgeons included CT in their work-up of facet fractures, regardless of the type. No statistically significant differences were seen in the need for MRI to decide treatment.

CONCLUSION

Considerable agreement exists between surgeon preferences with regard to unilateral facet fracture management with few exceptions. F2N2 fracture subtypes and subtypes with radiculopathy (N2) appear to be the threshold for operative treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Benneker, Lorin Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0940-6719

Publisher:

Springer

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

25 Jan 2022 17:53

Last Modified:

05 Dec 2022 16:02

Publisher DOI:

10.1007/s00586-021-06818-z

PubMed ID:

33797624

Uncontrolled Keywords:

AO Spine Global Imaging Subaxial Survey Treatment Unilateral facet fracture

BORIS DOI:

10.48350/164075

URI:

https://boris.unibe.ch/id/eprint/164075

Actions (login required)

Edit item Edit item
Provide Feedback