OBJECTIVES:The aim of this study was to review the literature on cervical spine fractures.METHODS:The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed.RESULTS:Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures.CONCLUSIONS:Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

Study DesignPilot test, observational study.ObjectiveTo evaluate objectively the knowledge transfer provided by theoretical and practical activities during AOSpine courses for spine surgeons.MethodsDuring two AOSpine principles courses, 62 participants underwent precourse assessment, which consisted of questions about their professional experience, preferences regarding adolescent idiopathic scoliosis (AIS) classification, and classifying the curves by means of the Lenke classification of two AIS clinical cases. Two learning strategies were used during the course. A postcourse questionnaire was applied to reclassify the same deformity cases. Differences in the correct answers of clinical cases between pre- and postcourse were analyzed, revealing the number of participants whose accuracy in classification improved after the course.ResultsAnalysis showed a decrease in the number of participants with wrong answers in both cases after the course. In the first case, statistically significant differences were observed in both curve pattern (83.3%, p  =  0.005) and lumbar spine modifier (46.6%, p  =  0.049). No statistically significant improvement was seen in the sagittal thoracic modifier (33.3%, p  =  0.309). In the second case, statistical improvement was obtained in curve pattern (27.4%, p  =  0.018). No statistically significant improvement was seen regarding lumbar spine modifier (9.8%, p  =  0.121) and sagittal thoracic modifier (12.9%, p  =  0.081).ConclusionThis pilot test showed objectively that learning strategies used during AOSpine courses improved the participants' knowledge. Teaching strategies must be continually improved to ensure an optimal level of knowledge transfer.

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Introduction AOSpine educational program was developed to expand knowledge and to promote integration among spine surgeons around the world. Nowadays, however, there are no available data of the effectiveness of the learning process and the level of competence acquired by participants in such activities. The aim of this study is to evaluate, objectively, the knowledge transfer provided thorough theoretical and practical activities during AOSpine courses for spine surgeons. Material and Methods During two principles courses of spine surgery, sixty-two participants underwent to pre-course assessment about their professional experience and preferences of adolescent idiopathic scoliosis (AIS) classification, as well as a test of curves by means of Lenke classification of two AIS clinical cases. Two learning strategies were used during the course: oral lectures and practical exercises. A post-course questionnaire was applied to retest the same deformity cases. Differences of correct answers of clinical cases between pre and post course were analyzed, revealing the number of participants who improve in the accuracy of the classification after the course. Results A total of 62 participants were included in the study, wherein 51 (82%) were orthopedic surgeons and 11 (18%) neurosurgeons. Analysis showed a decrease in the number of participants with wrong answer in both cases, after the course. In the first case, statistical significant differences were observed in both, curve pattern (83.3%, p = 0.005) and lumbar spine modifier (46.6%, p = 0.049). No statistical significant improvement was seen in sagittal thoracic modifier (33.3%, p = 0.309). On the second case, statistical improvement was obtained in curve pattern (27.4%, p = 0.018). No statistical significant improvement was seen regarding lumbar spine modifier (9.8%, p = 0.121) and sagittal thoracic modifier (12.9%, p = 0.081). Conclusion This study showed, objectively, that learning strategies used during AOSpine courses, improved the knowledge of participants. This knowledge acquisition was demonstrated through the decreased number of participants with wrong answers of two clinical cases, after the course. Teaching strategies must to be continually improved to ensure optimal level of knowledge transfer.