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

2021; Springer Science+Business Media; Volume: 30; Issue: 6 Linguagem: Inglês

10.1007/s00586-021-06818-z

1432-0932

Brian A. Karamian, Gregory D. Schroeder, Martin Holas, Andrei Fernandes Joaquim, José A. Canseco, Shanmuganathan Rajasekaran, Lorin M. Benneker, Frank Kandziora, Klaus J. Schnake, F. Cumhur Öner, Christopher K. Kepler, Alexander R. Vaccaro, Adetunji Toluse, Ahmad Arieff Atan, Ahmed Dawoud, Ahmed Shawky Abdelgawaad, Akbar Jaleel Zubairi, Alejandro Castillo, Alejo Vernengo-Lezica, Alessandro Ramieri, Alfredo Guiroy, Alkinoos Athanasiou, Alon Grundshtein, Amauri Godinho, Amin Henine, А. А. Grin, Andrey Pershin, Ariel Kaen, Arun Kumar Viswanadha, Babak Shariati, Balgopal Karmacharya, Barani Rathinavelu, Barón Zárate-Kalfópulos, Bhavuk Garg, Brandon J. Rebholz, Brett A. Freedman, Bruno Direito-Santos, Bruno Lourenço Costa, Bruno Saciloto, Catalin Majer, Chadi Tannoury, Christian Konrads, Christina W. Cheng, Chumpon Jetjumnong, Chun Kee Chung, Claudio Bernucci, Colin Harris, Craig D. Steiner, Cristian Valdez, Cristina Igualada, Cumhur Kılınçer, Darko Perović, David Orosco, David Ruiz Picazo, Derek T. Cawley, Desai Ankit, Devi Prakash Tokala, Dilip Gopalakrishnan, Emilija Stojkovska Pemovska, Eugen Cezar Popescu, Fabian Catarino Lopez Hinojosa, Fabricio Medina, Federico Landriel, Federico Sartor, Francisco A. Mannará, Guillermo Alejandro Ricciardi, Guillermo José López Espinosa, Gunaseelan Ponnusamy, Hassane Ali Amadou, Hugo Vilchis Sámano, Ignacio Garfinkel, Itati Romero, Jason Pui Yin Cheung, Jayakumar Subbiah, Jeevan Kumar Sharma, Jeronimo B. Milano, Jibin Francis, Jim Harrop, Joachim Vahl, Joana Guasque, João Morais, John Chen, John D. Koerner, Johnny Duerinck, Joost Rutges, Jose Alfredo Corredor, Jose Joefrey F. Arbatin, Jose Perozo, José-Carlos Sauri-Barraza, Juan Delgado-Fernández, Juan Esteban Muñoz Montoya, Juan Lourido, Konstantinos Margetis, Konstantinos Paterakis, Kubilay Murat Özdener, Lady Yemira Lozano Cari, Lingjie Fu, Luis Miguel Duchén Rodríguez, Luis Muñiz Luna, María de los Ángeles García Pallero, Mahmoud Alkharsawi, Mahmoud Elshamly, Mahmoud Shoaib, Marcelo Gruenberg, Marcelo Valacco, Marcus Vinicius De Oliveira Ferreira, Mario Ganau, Martín Estefan, Mauro Pluderi, Máximo-Alberto Díez-Ulloa, Mbarak Abeid, Mohamad Zaki Haji Mohd Amin, Mohamed Khattab, Mohammad El‐Sharkawi, Naohisa Miyakoshi, Nicola Nicassio, Noe Dimas, Nuno Nevès, Olga Carolina Morillo Acosta, Oscar González Guerra, Paulo Pereira, Pedro Luis Bazán, Phedy Phedy, Shyamasunder N Bhat, Pritchard, Rafael Blanco, Raghuraj Kundangar, Raphael Lotan, Ratko Yurac, Rian Souza Vieira, Ricardo Rodrigues‐Pinto, Ripul R. Panchal, Ronald Alberto Rioja Rosas, Rui Manilha, Salvatore Russo, Samuel Grozman, Sara Diniz, Scott C. Wagner, Sean R. Smith, Segundo Fuego, Seibert Franz, Selvaraj Ramakrishnan, Şevki Mustafa Demiröz, Shafiq Hackla, Sofien Benzarti, Stipe Ćorluka, Sung-Joo Yuh, Taolin Fang, Tarek Elhewala, Tarun Suri, Thami Benzakour, Valentine Mandizvidza, Vito Fiorenza, Wael Alsammak, Waheed Abdul, Waqar Hassan, Yasunori Sorimachi, Yohan Robinson, Zachary L. Hickman, Zdeněk Klézl,

Spine and Intervertebral Disc Pathology

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.A survey was sent to 272 members of the AO Spine Subaxial Injury Classification 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 Classification System, with various associated neurologic injuries.A total of 161 responses were received. Academic surgeons use the facet portion of the AO Spine classification 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, significantly 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, significantly 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 significant differences were seen in the need for MRI to decide treatment.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.