Regional and experiential differences in surgeon preference for the treatment of cervical facet injuries: a case study survey with the AO Spine Cervical Classification Validation Group

Abstract

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.

Motor Function of Children with SMA1 and SMA2 Depends on the Neck and Trunk Muscle Strength, Deformation of the Spine, and the Range of Motion in the Limb Joints

“…The biomechanical relationships, described by us, between the shape of the chest, the position of the pelvis, and the ranges of rotation in the cervical region may indicate that both pain and swallowing disorders may be related to the deformation of the spine. The characteristic scoliotic three-plane loss of alignment of the spine and pelvis change the position of the articular surfaces, which may lead to overloads and microinjuries and require appropriate diagnostics [37]. In addition, immobilization in the form of traction systems, collars, or braces, often used in SMA patients with scoliosis, may lead to secondary muscle weakness [38].…”

Establishing the Injury Severity of Subaxial Cervical Spine Trauma

“… 7 In terms of subspecialty training, although there is a higher proportion of orthopedic spine surgeons compared to neurosurgeons in our study, previous reports highlight high agreement on primary management decisions among spine specialists. 36 , 37 Although further studies with proportional subspecialty respondents will be helpful, perceived severity scores are unlikely to change.…”

Augmented Reality-Assisted Craniotomy for Parasagittal and Convexity En Plaque Meningiomas and Custom-Made Cranio-Plasty: A Preliminary Laboratory Report

“…This underscores its acceptance and importance as a neurosurgical operative aid and its potential to improve safety in neurosurgical procedures in the future [ 41 , 49 ]. The use of 3D stereoscopic AR visualization in the preoperative as well as in the intra-operative setting is deemed to improve the surgeon’s understanding of the anatomy and facilitate the tasks involved [ 41 , 50 , 51 , 52 , 53 ].…”