Naslov
Variation in global treatment for subaxial cervical spine isolated unilateral facet fractures

Autori
Brian A. Karamian, Gregory D. Schroeder, Martin Holas, Andrei F. Joaquim, Jose A. Canseco, Shanmuganathan Rajasekaran, Lorin M. Benneker, Frank Kandziora, Klaus J. Schnake, F. Cumhur Öner, Christopher K. Kepler, Alexander R. Vaccaro & AO Spine Subaxial Injury Classification System Validation Group

Izvornik
European spine journal (0940-6719) 30 (2021); 1635-1650

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
Unilateral facet fracture · Treatment · Imaging · Subaxial · AO Spine · Survey · Global

Sažetak
Purpose To determine the variation in the global treatment practices for subaxial unilateral cervical spine facet fractures based on surgeon experience, practice setting, and surgical subspecialty. Methods A survey was sent to 272 members of the AO Spine Subaxial Injury Classifcation System Validation Group worldwide. Questions surveyed surgeon preferences with regard to diagnostic work-up and treatment of fracture types F1–F3, according to the AO Spine Subaxial Cervical Spine Injury Classifcation System, with various associated neurologic injuries. Results A total of 161 responses were received. Academic surgeons use the facet portion of the AO Spine classifcation system less frequently (61.6%) compared to hospital-employed and private practice surgeons (81.1% and 81.8%, respectively) (p=0.029). The overall consensus was in favor of operative treatment for any facet fracture with radicular symptoms (N2) and for any fractures categorized as F2N2 and above. For F3N0 fractures, signifcantly less surgeons from Africa/Asia/Middle East (49%) and Europe (59.2%) chose operative treatment than from North/Latin/South America (74.1%) (p=0.025). For F3N1 fractures, signifcantly less surgeons from Africa/Asia/Middle East (52%) and Europe (63.3%) recommended operative treatment than from North/Latin/South America (84.5%) (p=0.001). More than 95% of surgeons included CT in their work-up of facet fractures, regardless of the type. No statistically signifcant diferences were seen in the need for MRI to decide treatment. Conclusion Considerable agreement exists between surgeon preferences with regard to unilateral facet fracture management with few exceptions. F2N2 fracture subtypes and subtypes with radiculopathy (N2) appear to be the threshold for operative treatment.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti, Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

POVEZANOST RADA