Purpose The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon's geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. Conclusion More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.

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Study Design: A multicenter observational survey. Objective: To quantify and compare inter- and intraobserver reliability of the subaxial cervical spine injury classification (SLIC) and the cervical spine injury severity score (CSISS) in a multicentric survey of neurosurgeons with different experience levels. Methods: Data concerning 64 consecutive patients who had undergone cervical spine surgery between 2013 and 2017 was evaluated, and we surveyed 37 neurosurgeons from 7 different clinics. All raters were divided into 3 groups depending on their level of experience. Two assessment procedures were performed. Results: For the SLIC, we observed excellent agreement regarding management among experienced surgeons, whereas agreement among less experienced neurosurgeons was moderate and almost twice as unlikely. The sensitivity of SLIC relating to treatment tactics reached as high as 92.2%. For the CSISS, agreement regarding management ranged from medium to substantial, depending on a neurosurgeon’s experience. For less experienced neurosurgeons, the level of agreement concerning surgical management was the same as for the SLIC in not exceeding a moderate level. However, this scale had insufficient sensitivity (slightly exceeding 50%). The reproducibility of both scales was excellent among all raters regardless of their experience level. Conclusions: Our study demonstrated better management reliability, sensitivity, and reproducibility for the SLIC, which provided moderate interrater agreement with moderate to excellent intraclass correlation coefficient indicators for all raters. The CSISS demonstrated high reproducibility; however, large variability in answers prevented raters from reaching a moderate level of agreement. Magnetic resonance imaging integration may increase sensitivity of CSISS in relation to fracture management.

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