AOSpine Needs Assessment

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Pipsa Ylanko, AOSpine Global Education Manager

Executive Editor: Luiz Vialle

Authors: Carlo Bellabarba, Marcelo Gruenberg, Cumhur Oner

Subaxial cervical trauma

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Glossary

Surgical procedures sorted by fracture type

Use this menu to jump directly into a specific classification (optional):
A0 A1 A2 A3 A4 B1 B2 B3 C
A0

Minor, nonstructural fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative (collars) All A0 fractures Basic surgical experience, no specialized skills Basic equipment only
A1

Compression fracture single endplate

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative (collars) Small wedge fracture; unconscious patient Basic surgical experience, no specialized skills Basic equipment only
Nonoperative (halo vest) Only indicated in selected cases Some specialized surgical experience Simple surgical and imaging resources
Anterior plating Severe wedging; polytrauma; SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources
A2

Coronal split/pincer fracture

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative (collars) All undisplaced A2 fractures; unconscious patient Basic surgical experience, no specialized skills Basic equipment only
Nonoperative (halo vest) Only indicated in selected cases Some specialized surgical experience Simple surgical and imaging resources
Combined anterior and posterior (360) Grossly displaced A2 fractures at the cervico thoracic junction Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior plating Grossly displaced A2 fractures; polytrauma; SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources
A3

Burst fracture of single endplate

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative (collars) Stable undisplaced A3 fractures; unconscious patient Basic surgical experience, no specialized skills Basic equipment only
Nonoperative (halo vest) Only indicated in selected cases Basic surgical experience, no specialized skills Basic equipment only
Combined anterior and posterior (360) A3 fractures at the cervico thoracic junction; spinal cord compression Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior plating All unstable or displaced A3 fractures; polytrauma; SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources
A4

Burst fracture or sagittal split involving both endplates

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative (collars) Stable undisplaced A4 fractures; unconscious patient Basic surgical experience, no specialized skills Basic equipment only
Nonoperative (halo vest) Only indicated in selected cases Some specialized surgical experience Simple surgical and imaging resources
Combined anterior and posterior (360) A4 fractures at the cervico thoracic junction; spinal cord compression Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior plating All unstable or displaced A4 fractures; polytrauma; SCI Basic surgical experience, no specialized skills Full specialized surgical and imaging resources
B1

Posterior tension band injury (bony)

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonoperative (collars) Minor B1 fractures; unconscious patient Basic surgical experience, no specialized skills Basic equipment only
Cervical spine - posterior fixation Excessive posterior bony gap, polytrauma, SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B2

Posterior tension band injury (bony capsuloligamentous, ligamentous)

Please select a treatment option:
Treatment Main indication Skill Equipment
Cervicothoracic junction - posterior fixation Pure posterior ligamentous injures, facet injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Cervical spine - posterior fixation Pure posterior ligamentous injures, facet injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior (360) B2 fractures at the cervico thoracic junction; spinal cord compression Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior plating All B2 fractures; polytrauma; SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources
B3

Antgerior tension band injury

Please select a treatment option:
Treatment Main indication Skill Equipment
Cervicothoracic junction - posterior fixation Pure posterior ligamentous injures, facet injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Cervical spine - posterior fixation Stiff spine Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior plating All B3 fractures; polytrauma; SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources
C

Translational injury

Please select a treatment option:
Treatment Main indication Skill Equipment
Cervicothoracic junction - posterior fixation All C fractures at the cervico thoracic junction Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Cervical spine - posterior fixation All type C injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Combined anterior and posterior (360) All C fractures at the cervico thoracic junction Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Anterior plating All type C fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Special considerations

Pediatric fractures
Ankylotic spine
Postoperative deformities
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources