Current Reviews in Musculoskeletal Medicine

, Volume 9, Issue 4, pp 496–504 | Cite as

Subaxial cervical spine trauma

  • Eric Feuchtbaum
  • Jacob Buchowski
  • Lukas Zebala
Cervical Injuries and Treatment (HJ Kim, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cervical Injuries and Treatment


Subaxial cervical spine trauma is common and an often missed diagnosis. Accurate and efficient diagnosis and management is necessary to avoid devastating complications such as spinal cord injury. Several classification schemes have been devised to help categorize fractures of the subaxial spine and define treatment algorithms. The Subaxial Cervical Spine Injury Classification System (SLIC) is widely used and evaluates not only fracture morphology but also considers ligamentous injury and neurological status in surgical decision making. However, interobserver reliability is poor, which proves to be the defining pitfall of this tool. More modern classification systems have been developed, which aim to improve the interobserver reliability; however, further large-scale studies are needed for more definitive evaluation. Overall, treatment of subaxial cervical spine injuries should include a protocol with initial trauma evaluation, leading to expedient operative intervention if indicated. Surgical techniques include both anterior and posterior approaches to the cervical spine depending on fracture classification.


Subaxial cervical spine trauma Fracture Ligamentous injury Classification system 


Compliance with ethical standards

Conflict of interest

Eric Feuchtbaum declares that he has no conflict of interest.

Jacob Buchowski reports personal fees from Advance Medical, personal fees from CoreLink Inc., personal fees from DePuy Synthes, personal fees from Gerson Lehrman Group (GLG), personal fees from Globus Medical Inc., personal fees from K2M Inc., personal fees from Medtronic Inc., personal fees from Stryker Inc., personal fees from Broadwater/Vertical Health, personal fees from DePuy Synthes, personal fees from Globus Medical Inc., personal fees from Orthofix, personal fees from Stryker Inc., personal fees from Wolters Kluwer Health Inc., and personal fees from Globus Medical Inc., outside the submitted work. In addition, Dr. Buchowski has a patent CAPRI (spinal fixation device) with royalties paid to K2M Inc. and AO Foundation (parent organization to AOSpine), “other,” “teaching,” and “not for profit organization.”

Lukas Zebala reports personal fees from K2M, personal fees from Ulrich Medical USA, personal fees from Broadwater, personal fees from K2M, non-financial support from Scoliosis Research Society, non-financial support from Depuy Synthes Spine, non-financial support from Medtronic, and non-financial support from Nuvasive, outside the submitted work.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Eric Feuchtbaum
    • 1
  • Jacob Buchowski
    • 1
  • Lukas Zebala
    • 1
  1. 1.Department of Orthopedic SurgeryWashington University School of MedicineSt. LouisUSA

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