AO Spine Upper Cervical Injury Classification System

J.Sales-Llopis

Neurosurgery Service, Alicante University General Hospital, Alicante, Spain.

• The Reliability of the AO Spine Upper Cervical Classification System in Children: Results of a Multi-Center Study
• Global Validation of the AO Spine Upper Cervical Injury Classification: Geographic Region Affects Reliability and Reproducibility
• The AO spine upper cervical injury classification system: Do work setting or trauma center affiliation affect classification accuracy or reliability?
• Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System
• AO Spine upper cervical injury classification system: a description and reliability study
• Global Validation of the AO Spine Upper Cervical Injury Classification
• Fifty years later: the "rule of Spence" is finally ready for retirement
• Subaxial spine trauma: radiological approach and practical implications

see AO Spine Upper Cervical Injury Classification System

In the pediatric population. While moderate to substantial agreement was found, limitations to applying the Upper Cervical Injury Classification System to the pediatric population exist, and thus the UCCS can be considered a starting point for developing a pediatric classification ¹⁾

Early phase validation demonstrated classification of upper cervical spine injuries using the AO Spine Upper Cervical Injury Classification System to be accurate, reliable, and reproducible. Greater than 80% accuracy was detected for injury classification. The intraobserver reproducibility was excellent, while the interobserver reliability was substantial ²⁾

The AO Spine Upper Cervical Injury Classification System can be applied with high accuracy, interobserver reliability, and intraobserver reproducibility. However, lower classification accuracy and reliability were found in regions of Africa and Central/South America, especially for severe atlas injuries (IIB and IIC) and atypical hangman's type fractures (IIIB injuries) ³⁾.

A study reported an acceptable reproducibility of the new AO UCCS and safety in recommending the treatment. Further clinical studies with a larger patient sample, multicenter and international, are necessary to sustain the universal and homogeneity quality of the new AO UCCS ⁴⁾

AO Spine Upper Cervical Injury Classification System Type A

• Global Validation of the AO Spine Upper Cervical Injury Classification: Geographic Region Affects Reliability and Reproducibility
• The AO spine upper cervical injury classification system: Do work setting or trauma center affiliation affect classification accuracy or reliability?
• AO Spine upper cervical injury classification system: a description and reliability study
• Global Validation of the AO Spine Upper Cervical Injury Classification
• Fifty years later: the "rule of Spence" is finally ready for retirement
• Surgically Treated C1 Fractures: A Population-Based Study
• Reliability of the New AOSpine Classification System for Upper Cervical Traumatic Injuries
• Management of Odontoid Fractures with Compression Screw and Anterior Transarticular Screw Fixation in Elderly Patients

I. Occipital Condyle and Craniocervical junction. Isolated bony injury (condyle) Isolated bony injury (condyle)

II. C1 Ring and C1-2 Joint. Isolated bony only (arch)

III. C2 and C2-3 Joint. Bony injury only without ligamentous, tension band, discal injury

Type B injuries are the most difficult injury type to correctly classify. They are classified with greater reliability and classification accuracy when evaluated by academic surgeons, hospital-employed surgeons, and surgeons associated with higher-level trauma centers (I or II/III) ⁵⁾

see also Atlas fracture classification

see also Axis fracture classification,

AOSpine subaxial cervical spine injury classification system.

The AO classification according to Magerl et al. is used for the subaxial spine, whereas the upper cervical spine should be classified separately because the anatomy is different at each level ⁶⁾