Detection of cervical spine trauma: Are 3-dimensional reconstructed images as accurate as multiplanar computer tomography?

Enabling Technologies in the Management of Cervical Spine Trauma

STUDY DESIGN

Narrative review.

OBJECTIVE

The objective of this study is to explore and evaluate the role of novel technologies in enhancing the diagnosis, surgical precision, and rehabilitation of cervical spine trauma, and to discuss their potential impact on clinical outcomes.

SUMMARY OF BACKGROUND DATA

Traumatic cervical spine injuries are challenging to manage due to their complex anatomy, the potential for long-term disability, and severe neurological deficits. Traditional management approaches are being supplemented by emerging technologies that promise to improve patient care and outcomes.

METHODS

A literature review was conducted to identify and analyze advancements in imaging, navigation, robotics, and wearable technologies in the context of cervical spine trauma. The review focuses on the potential of these technologies to improve early detection, surgical accuracy, and postoperative recovery.

RESULTS

Technological innovations, including advanced imaging techniques, machine learning for diagnostics, augmented reality, and robotic-assisted surgery, are transforming the management of cervical spine trauma. These tools contribute to more efficient, accurate, and personalized treatment approaches, potentially improving clinical outcomes and reducing patient care burdens.

CONCLUSIONS

Although these technologies hold great promise, challenges such as implementation costs and the need for specialized training must be addressed. With continued research and interdisciplinary collaboration, these advancements can significantly enhance the management of cervical spine trauma, improving patient recovery and quality of life.

LEVEL OF EVIDENCE

Level V.

Cervical spine trauma: impact of different imaging classification systems in the clinical decision-making

Background and aim:

Considering the high rate of mortality and permanent disability related to vertebral traumas, an early and detailed diagnosis of the trauma and subsequently an immediate and effective intervention are crucial. Cervical vertebral injury classifications guide treatment choice through a severity grade based on radiological information. The purpose of the present study was to define which imaging classification system could provide the best morphological and clinical-surgical correlations for cervical spine traumas.

Methods:

We retrospectively analyzed patients evaluated for cervical spine trauma at our Institution in the period 2015-2020. Information regarding the morphological examination (using CT and MRI), the neurological evaluation, and the therapeutic management were collected. C3-C7 fractures were classified according to the SLIC and AOSpine criteria; axial lesions were classified according to the modified AOSpine for the C1-C2 compartment and through the Roy-Camille and the Anderson D’Alonzo system for the odontoid process of the axis.

Results:

29 patients were included in the final study population. Nine patients with axial spine trauma and 21 with subaxial cervical spine trauma. A conservative approach was applied in 16 patients while nine patients underwent neurosurgery. Considering the therapeutical indications provided by the SLIC system, a 76.9% accordance was found for patients with a <4 score, while a 100% concordance was calculated for patients with a >4 score undergoing neurosurgery. Regarding the AOSspine classification, a 28.6% concordance was observed for patients classified group B being treated with a posterior neurosurgical approach, while for patients belonging to subgroup C, considered for anterior neurosurgical approach, a 66.7% accordance was calculated.

Conclusions:

The study demonstrated a better morphological correlation for the AOSpine classification in subaxial trauma and the AOSpine and Anderson D’Alonzo in axial trauma. The therapeutic indication found a better correlation in the SLIC classification for subaxial trauma and the Anderson D’Alonzo for axial ones. (www.actabiomedica.it)