Abstract:

BACKGROUND: Spine injury classification system has an important guiding sense to diagnosis, treatment and prognosis of sub-axial cervical spine injury, but it lacks a widely accepted classification system clinically.
OBJECTIVE: To evaluate the reliability and validity of the sub-axial injury classification system and to explore its role in the clinical application.
METHODS: Seventy-five patients with lower cervical spine injury were treated based on the sub-axial injury classification system. The 11 cases of less than 4 points received conservative treatment, according to fracture morphology, disco-ligamentous complex status and neurologic status, six cases of 4 points and 58 cases of more than 4 points received surgical treatment through different approach. Cronbach’s α coefficient and Kappa coefficient were used respectively to investigate internal consistency reliability and retest reliability, index of content validity was used to inspect content validity.
RESULTS AND CONCLUSION: The internal consistency reliability of sub-axial injury classification system was greater than 0.8, it indicated that the system had a high reliability. The retest reliability of disco-ligamentous complex and sub-axial injury classification system was moderately credible, the retest reliability of Kappa coefficients of morphology, neurologic status and proposed management were greater than 0.6. Average value of content validity index was 0.936, which proved that all entries of sub-axial injury classification system could guide the diagnosis and treatment of lower cervical injury nicely. Seventy-five patients with lower cervical spine injury were treated by the system with low incidence of complications
and there was no aggravation of neurological status, and the ASIA grade was improved. Sub-axial injury classification system has the advantages of high reliability and validity, simple use and easy master, and plays an important role in guiding the surgical decision and surgical approach.