TY - JOUR
T1 - Variation in global treatment for subaxial cervical spine isolated unilateral facet fractures
AU - AO Spine Subaxial Injury Classification System Validation Group
AU - Karamian, Brian A.
AU - Schroeder, Gregory D.
AU - Holas, Martin
AU - Joaquim, Andrei F.
AU - Canseco, Jose A.
AU - Rajasekaran, Shanmuganathan
AU - Benneker, Lorin M.
AU - Kandziora, Frank
AU - Schnake, Klaus J.
AU - Öner, F. Cumhur
AU - Kepler, Christopher K.
AU - Vaccaro, Alexander R.
AU - Toluse, Adetunji
AU - Atan, Ahmad Arieff
AU - Dawoud, Ahmed
AU - Abdelgawaad, Ahmed Shawky
AU - Zubairi, Akbar
AU - Castillo, Alejandro
AU - Vernengo-Lezica, Alejo
AU - Ramieri, Alessandro
AU - Guiroy, Alfredo
AU - Athanasiou, Alkinoos
AU - Grundshtein, Alon
AU - Godinho, Amauri
AU - Henine, Amin
AU - Grin, Andrey
AU - Pershin, Andrey
AU - Kaen, Ariel
AU - Viswanadha, Arun Kumar
AU - Shariati, Babak
AU - Karmacharya, Balgopal
AU - Rathinavelu, Barani
AU - Zarate-Kalfopulos, Baron
AU - Garg, Bhavuk
AU - Rebholz, Brandon
AU - Freedman, Brett
AU - Direito-Santos, Bruno
AU - Costa, Bruno Lourenço
AU - Saciloto, Bruno
AU - Majer, Catalin
AU - Tannoury, Chadi
AU - Konrads, Christian
AU - Cheng, Christina
AU - Jetjumnong, Chumpon
AU - Chung, Chun Kee
AU - Bernucci, Claudio
AU - Harris, Colin
AU - Steiner, Craig D.
AU - Valdez, Cristian
AU - Wagner, Scott
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - AO Spine
KW - Global
KW - Imaging
KW - Subaxial
KW - Survey
KW - Treatment
KW - Unilateral facet fracture
UR - http://www.scopus.com/inward/record.url?scp=85103651345&partnerID=8YFLogxK
U2 - 10.1007/s00586-021-06818-z
DO - 10.1007/s00586-021-06818-z
M3 - Article
C2 - 33797624
AN - SCOPUS:85103651345
SN - 0940-6719
VL - 30
SP - 1635
EP - 1650
JO - European Spine Journal
JF - European Spine Journal
IS - 6
ER -