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Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center
Neurospine. 2025;22(4):905-915.   Published online December 31, 2025
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Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center
Neurospine. 2025;22(4):905-915.   Published online December 31, 2025
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Objective
Traumatic vertebral artery injuries (tVAIs) are uncommon but potentially devastating if missed. While computed tomography angiography (CTA) is routinely used for diagnosis, data on the number needed to image (NNI) remain limited. We hence analyzed tVAI epidemiology and imaging practices at a major Scandinavian level 1 trauma center.
Methods
A retrospective study (2013–2020) was performed based on a single-center trauma registry. Patients were grouped based on CTA imaging protocol used; selective screening (2013–2017) and universal screening (2018–2020). Imaging protocols, treatment strategies, and outcomes were analyzed.
Results
Among 2,843 patients admitted with level 1 trauma and receiving CTA imaging, 62 had a tVAI (2.2%) yielding a NNI of 46 patients to diagnose 1 tVAI. Twenty-five of these patients (40.3%) were found to have a posterior circulation stroke, resulting in an incidence of 0.9%, and a NNI of 114 to diagnose 1 stroke on CTA. NNIs for both tVAI and stroke detection increased with adoption of universal screening (tVAI: 35→65; stroke: 90→149). However, the detection rate of tVAI during the universal screening period was not significantly higher than during the selective screening period (p=0.261).
Conclusion
In our level 1 trauma cohort, the incidence of tVAI was 2.2% and stroke rate 0.9%. The NNI rose with universal screening, yet detection rates did not improve. These findings suggest that selective screening based on risk factors may be more efficient than a universal approach. Further research is needed to balance diagnostic accuracy with resource use in trauma care.

Citations

Citations to this article as recorded by  Crossref logo
  • Optimizing Diagnostic Yield: Evidence Against Universal Computed Tomography Angiography for Traumatic Vertebral Artery Injury Screening – A Commentary on “Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Tr
    Jae Taek Hong
    Neurospine.2025; 22(4): 916.     CrossRef
  • From the Editor-in-Chief: Featured Articles in the December 2025 Issue
    Inbo Han
    Neurospine.2025; 22(4): 877.     CrossRef
  • 1,671 View
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  • 2 Web of Science
  • 2 Crossref

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Risk Analysis Index and Its Recalibrated Version Predict Postoperative Outcomes Better Than 5-Factor Modified Frailty Index in Traumatic Spinal Injury
Neurospine. 2022;19(4):1039-1048.   Published online December 31, 2022
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Risk Analysis Index and Its Recalibrated Version Predict Postoperative Outcomes Better Than 5-Factor Modified Frailty Index in Traumatic Spinal Injury
Neurospine. 2022;19(4):1039-1048.   Published online December 31, 2022
Close
Objective
To assess the discriminative ability of the Risk Analysis Index-administrative (RAI-A) and its recalibrated version (RAI-Rev), compared to the 5-factor modified frailty index (mFI-5), in predicting postoperative outcomes in patients undergoing surgical intervention for traumatic spine injuries (TSIs).
Methods
The Current Procedural Terminology (CPT) and International Classification of Disease-9 (ICD-9) and ICD-10 codes were used to identify patients ≥ 18 years who underwent surgical intervention for TSI from National Surgical Quality Improvement Program (ACS-NSQIP) database 2015–2019 (n = 6,571). Multivariate analysis and receiver operating characteristic (ROC) curve analysis were conducted to evaluate the comparative discriminative ability of RAI-Rev, RAI-A, and mFI-5 for 30-day postoperative outcomes.
Results
Multivariate regression analysis showed that with all 3 frailty scores, increasing frailty tiers resulted in worse postoperative outcomes, and patients identified as frail and severely frail using RAI-Rev and RAI-A had the highest odds of poor outcomes. In the ROC curve/C-statistics analysis for prediction of 30-day mortality and morbidity, both RAI-Rev and RAI-A outperformed mFI-5, and for many outcomes, RAI-Rev showed better discriminative performance compared to RAI-A, including mortality (p = 0.0043, DeLong test), extended length of stay (p = 0.0042), readmission (p < 0.0001), reoperation (p = 0.0175), and nonhome discharge (p < 0.0001).
Conclusion
Both RAI-Rev and RAI-A performed better than mFI-5, and RAI-Rev was superior to RAI-A in predicting postoperative mortality and morbidity in TSI patients. RAI-based frailty indices can be used in preoperative risk assessment of spinal trauma patients.

Citations

Citations to this article as recorded by  Crossref logo
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Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study
Neurospine. 2022;19(4):1013-1025.   Published online October 23, 2022
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Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study
Neurospine. 2022;19(4):1013-1025.   Published online October 23, 2022
Close
Objective
This multicenter study compared radiological parameters and clinical outcomes between surgical and nonsurgical management and investigated treatment characteristics associated with the successful management of unstable atlas fractures.
Methods
We retrospectively evaluated 53 consecutive patients with unstable atlas fracture who underwent halo-vest immobilization (HVI) or surgical fixation. Clinical outcomes were assessed using neck visual analogue scale and disability index. The radiological assessment included total lateral mass displacement (LMD) and the anterior atlantodental interval (AADI).
Results
Thirty-two patients underwent surgical fixation and 21 received HVI (mean follow-up, 24.9 months). In the surgical fixation, but not in the HVI, LMD, and AADI showed statistically significant improvements at the last follow-up. The osseous healing rate and time-to-healing were 100% and 14.3 weeks with surgical fixation, compared with 71.43% and 20.0 weeks with HVI, respectively. Patients treated with HVI showed poorer neck pain and neck disability outcomes than those who received surgical treatment. LMD showed an association with osseous healing outcomes in nonoperative management. Clinical outcomes and osseous healing showed no significant differences according to Dickman’s classification of transverse atlantal ligament injuries.
Conclusion
Surgical internal fixation had a higher fusion rate, shorter fracture healing time, more favorable clinical outcomes, and a more significant reduction in LMD and AADI compared to nonoperative management. The pitfalls of external immobilization are inadequate maintenance and a lower probability of reducing fractured lateral masses. Stabilization by surgical reduction with interconnected fixation proved to be a more practical management strategy than nonoperative treatment for unstable atlas fractures.

Citations

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  • Motion preserving C1 ring lateral mass screw fixation with transverse rod for isolated unstable Jefferson fracture of atlas vertebra: a multicentric study
    Nathan Beucler, Anis Choucha, Kaissar Farah, Mikael Meyer, Arnaud Dagain, Stéphane Fuentes
    European Spine Journal.2026; 35(2): 936.     CrossRef
  • Anatomical basis for a new method of atlas osteosynthesis in unstable C1 vertebra fractures
    V.N. Rashidov, I.Yu. Lisitskii, A.V. Lychagin, R.L. Kambiev, K.M. Kulakov, A.Yu. Zarov, A.L. Korkunov, V.G. Cherepanov, I.A. Vyazankin, E.Yu. Tselischeva
    Burdenko's Journal of Neurosurgery.2026; 90(2): 37.     CrossRef
  • Clinical study of three internal fixation systems via transoral approach for motor function preservation in atlas fractures
    Yinghua He, Hu Chen, Hanmo Gu, Yansong Liu, Zhongbiao Liang, Xiangyang Ma, Jinahua Wang, Kai Zhang, Qiang Tu
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Original surgical technique of unstable atlas fracture osteosynthesis: case series analysis
    I. Yu. Lisitsky, V. N. Rashidov, A. V. Lychagin, A. Yu. Zarov, A. L. Korkunov, V. G. Cherepanov, I. A. Vyazankin, E. Yu. Tselishcheva
    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2025; 22(1): 53.     CrossRef
  • Perioperative outcomes and technical and patient-reported success of rigid occipitocervical fusions in adults: a systematic review and meta-analysis
    Alexander O. Aguirre, Mohamed A.R. Soliman, Isabelle G. Stockman, Gaitree R. Boojraj, Esteban Quiceno, Asham Khan, Kyungduk Rho, John Pollina, Jeffrey P. Mullin
    European Spine Journal.2025; 34(8): 3408.     CrossRef
  • More postoperative complications and revision surgery after occipitocervical fusion than after atlantoaxial fusion: a retrospective multicenter cohort study
    Koji Uotani, Angel Oscar Paz Flores, Masato Tanaka, Shashank J Ekade, Shinya Arataki, Tadashi Komatsubara, Yoshiaki Oda, Kensuke Shinohara, Toshifumi Ozaki
    Asian Spine Journal.2025; 19(3): 444.     CrossRef
  • Craniocervical traumatic ligamentous injuries – AO spine type B injuries – Anatomy, biomechanics and clinical perspectives
    Andrei Fernandes Joaquim, Klaus John Schnake, Richard J. Bransford, Harvinder Singh Chabbra, Sebastian F. Bigdon, Mohammad El-Sharkawi, Gregory D. Schroeder
    Journal of Clinical Orthopaedics and Trauma.2025; 71: 103223.     CrossRef
  • Radiological and Clinical Outcomes of Monoaxial versus Polyaxial Screw Constructs in C1 Jefferson Fracture Osteosynthesis: A Retrospective Study
    Jae Taek Hong, Dong Hoon Kim, Jin Young Kim, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
    World Neurosurgery.2025; 204: 124578.     CrossRef
  • Evaluation of the Classification Systems Used for Traumatic Atlas (C1) Injuries
    Thiago Magalhães De Souza, Lucas Dos Santos Pavesi, Andrei Fernandes Joaquim
    Clinical Spine Surgery.2025;[Epub]     CrossRef
  • Direct C1 posterior arch screws for reduction and osteosynthesis in the treatment of Jefferson fracture
    Chang Kyu Park, Man Kyu Choi
    Acta Neurochirurgica.2024;[Epub]     CrossRef
  • Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis
    He-Gang Niu, Jing-Jing Zhang, Yi-Zhu Yan, Cheng-Kun Zhao, Kun Yang, Yin-Shun Zhang
    Journal of Orthopaedic Surgery and Research.2024;[Epub]     CrossRef
  • Comparison of Transoral Anterior Jefferson-Fracture Reduction Plate and Posterior Screw-Rod Fixation in C1-Ring Osteosynthesis for Unstable Atlas Fractures
    Mandi Cai, Yifeng Wu, Rencai Ma, Junlin Chen, Zexing Chen, Chenfu Deng, Xinzhao Huang, Xiangyang Ma, Xiaobao Zou
    Neurospine.2024; 21(2): 544.     CrossRef
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    I. V. Basankin, Abram Akopovich Giulzatyan, I. M. Magomedov, K. K. Takhmazyan, M. I. Tomina, S. B. Malakhov, A. A. Afaunov, V. A. Porkhanov
    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2024; 21(3): 6.     CrossRef
  • Commentary on “Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study”
    Toshiyuki Takahashi
    Neurospine.2022; 19(4): 1026.     CrossRef
  • 14,197 View
  • 797 Download
  • 9 Web of Science
  • 14 Crossref

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Demographic Predictors of Treatment and Complications for Spinal Disorders: Part 2, Lumbar Spine Trauma
Neurospine. 2021;18(4):725-732.   Published online December 31, 2021
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Demographic Predictors of Treatment and Complications for Spinal Disorders: Part 2, Lumbar Spine Trauma
Neurospine. 2021;18(4):725-732.   Published online December 31, 2021
Close
Objective
To study the impact of demographic factors on management of traumatic injury to the lumbar spine and postoperative complication rates.
Methods
Data was obtained from the National Inpatient Sample (NIS) between 2010–2014. International Classification of Diseases, 9th revision, Clinical Modification codes identified patients diagnosed with lumbar fractures or dislocations due to trauma. A series of multivariate regression models determined whether demographic variables predicted rates of complication and revision surgery.
Results
A total of 38,249 patients were identified. Female patients were less likely to receive surgery and to receive a fusion when undergoing surgery, had higher complication rates, and more likely to undergo revision surgery. Medicare and Medicaid patients were less likely to receive surgical management for lumbar spine trauma and less likely to receive a fusion when operated on. Additionally, we found significant differences in surgical management and postoperative complication rates based on race, insurance type, hospital teaching status, and geography.
Conclusion
Substantial differences in the surgical management of traumatic injury to the lumbar spine, including postoperative complications, among individuals of demographic factors such as age, sex, race, primary insurance, hospital teaching status, and geographic region suggest the need for further studies to understand how patient demographics influence management and complications for traumatic injury to the lumbar spine.

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  • Identification of an Operative Time Threshold for Substantially Increased Postoperative Complications After Thoracolumbar Spine Surgery: A Nationwide Retrospective Cohort Analysis
    Bilal Moiz, Khaled M. Taghlabi, Isuru Somawardana, Rijul Nanda, Lokeshwar S. Bhenderu, Jaime R. Guerrero, Aboud Tahanis, Amir H. Faraji
    World Neurosurgery.2025; 197: 123897.     CrossRef
  • Racial Disparities in Time to Decompression in Central Cord Syndrome: A National Trauma Database Analysis
    Daniel Deysher, Sam H. Jiang, Harsh Khilwani, Mehul Patnam, Mounika Bhaskara, Syed Khalid, Ryan G. Chiu, Ankit I. Mehta
    World Neurosurgery.2023; 177: e146.     CrossRef
  • 12,206 View
  • 236 Download
  • 2 Web of Science
  • 2 Crossref

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Kyphosis After Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Neurospine. 2021;18(4):681-692.   Published online December 31, 2021
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Kyphosis After Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Neurospine. 2021;18(4):681-692.   Published online December 31, 2021
Close
Thoracolumbar fractures change the biomechanics of the spine. Load distribution causes kyphosis by the time. Treatment of posttraumatic kyphosis is still controversial. We reviewed the literature between 2010 and 2020 using a search with keywords “thoracolumbar fracture and kyphosis.” We removed osteoporotic fractures, ankylosing spondylitis fractures, non-English language papers, case reports, and low-quality case series. Up-to-date information on posttraumatic kyphosis management was reviewed to reach an agreement in a consensus meeting of the World Federation of Neurosurgical Societies (WFNS) Spine Committee. The first meeting was conducted in Peshawar in December 2019 with WFNS Spine Committee members’ presence and participation. The second meeting was a virtual meeting via the internet on June 12, 2020. We utilized the Delphi method to administer the questionnaire to preserve a high degree of validity. We summarized 42 papers on posttraumatic kyphosis. Surgical treatment of thoracolumbar kyphosis due to unstable burst fractures can be done via a posterior only approach. Less blood loss and reduced surgery time are the main advantages of posterior surgery. Kyphosis angle for surgical decision and fusion levels are controversial. However, global sagittal balance should be taken into consideration for the segment that has to be included. Adding an intermediate screw at the fractured level strengthens the construct.

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    Inwook Seo, Minjoon Cho, Taehoon Kang, Sungtaek Chung, Jae Hyup Lee
    European Spine Journal.2026; 35(5): 2622.     CrossRef
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    Shibao Lu, Xiangyu Li, Xiaolong Chen, Zheng Wang, Yu Wang, Weiguo Zhu, Wei Wang, Chao Kong, Dongfan Wang
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    Anis Choucha, Morgane Evin, Matteo de Simone, Guillaume Dannhoff, Henry Dufour, Valentin Avinens, Kaissar Farah, Florian Saby, Stephane Fuentes
    Neurochirurgie.2026; 72(1): 101764.     CrossRef
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    Lei He, Yi Hong, Zhenan Chen, Cong Jin, Feiyue Lin
    European Journal of Medical Research.2026;[Epub]     CrossRef
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    Luyang Wang, Tian Zhou, Qianmei Gao, Xizhong Zhu, Xingchen Li, Haiyang Wu, Yusheng Xu
    World Neurosurgery.2026; 206: 124772.     CrossRef
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    Cureus.2026;[Epub]     CrossRef
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    Mostafa K. Ghobashy, Mohamed AR AbdelFatah, Mohamed Elsayed Youssef, Sameh Hefny
    European Spine Journal.2026;[Epub]     CrossRef
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    Masato Tanaka, Aditya Thakur, Muhamad A Rahman, Akshay Fuse, Shinya Arataki, Tadashi Komatsubara, Akiyoshi Miyamoto, Masakazu Nagamatsu, Tomoyoshi Sakaguchi
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  • 15,653 View
  • 297 Download
  • 21 Web of Science
  • 28 Crossref

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Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Neurospine. 2021;18(4):667-680.   Published online December 31, 2021
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Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
Neurospine. 2021;18(4):667-680.   Published online December 31, 2021
Close
To formulate the specific guidelines for the recommendation of thoracolumbar fracture regarding surgical techniques and nonfusion surgery. WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meeting. For nonfusion surgery and thoracolumbar fracture, a systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020. The search was further refined by excluding the articles which were duplicate, not in English or were based on animal or cadaveric subjects. After thorough shortlisting, only 50 articles were selected for full review in this consensus meeting. To generate a consensus, the levels of agreement or disagreement on each item were voted independently in a blind fashion through a Likert-type scale from 1 to 5. The consensus was achieved when the sum for disagreement or agreement was ≥ 66%. Each consensus point was clearly defined with evidence strength, recommendation grade, and consensus level provided. A magnitude of prospective papers were analyzed to formulate consensus on various surgical techniques that can be employed to address different types of thoracolumbar fractures. Surgical treatment of thoracolumbar fractures can be a better option over the nonoperative approach, especially for those who cannot tolerate months in an orthosis or cast, such as those with multiple extremity injuries, skin lesions, obesity, and so forth. It generally allows early mobilization, less hospital stay, reduced pulmonary complications, and better correction of sagittal balance. Current available literature fails to demonstrate any statistically significant benefit of fusion surgery over nonfusion in thoracolumbar fractures.

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    TERRA ORTHOPAEDICA.2026; (1(128)): 30.     CrossRef
  • The Role of Intermediate Screws in the Bone-Screw-Rod Construct for A1 Fractures of the Thoracolumbar Junction
    O.S. Nekhlopochyn, V.V. Verbov, Ye.V. Cheshuk, M.Yu. Karpinskyi, O.V. Yaresko
    TERRA ORTHOPAEDICA.2026; (1(128)): 30.     CrossRef
  • Delay in Surgical Fixation of Operatively Treated Thoracolumbar Fractures in the Elderly Associated With Minimal Increase in Short-Term Complications
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    Medicine.2025; 104(23): e42699.     CrossRef
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Pediatric Cervical Spine Injuries and SCIWORA: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):797-808.   Published online December 31, 2020
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Pediatric Cervical Spine Injuries and SCIWORA: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):797-808.   Published online December 31, 2020
Close
Cervical trauma in children have variations from the adults mainly due to anatomic differences. An optimal diagnostic and treatment strategy is critical, particularly when there is a lack of standardized protocols for the management of such cases. This review paper examines the diagnostic and treatment options of pediatric cervical trauma and Spinal Cord Injury Without Radiographic Abnormality (SCIWORA). A literature search for the last 10 years were conducted using key words. Case reports, experimental studies, papers other than English language were excluded. Up-to-date information on pediatric cervical trauma and SCIWORA were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of WFNS Spine Committee. The statements were voted and reached a consensus using Delphi method. This review reflects different aspects of contemporary pediatric cervical trauma decision-making and treatment, and SCIWORA. The mainstay of SCIWORA treatment is nonsurgical with immobilization, avoidance of risky activities. Prognosis generally depends on the initial neurological status and magnetic resonance imaging. Due to a significant discrepancy in the literature on diagnostic and management, future randomized controlled trials are needed to aid in generating standardized protocols.

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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):710-722.   Published online December 31, 2020
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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):710-722.   Published online December 31, 2020
Close
Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.

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  • Exploring perspectives and adherence to guidelines for adult spinal trauma in low and middle-income healthcare economies: A survey on barriers and possible solutions (part I)
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    Brain and Spine.2022; 2: 100932.     CrossRef
  • Osteoporotic vertebral fractures: WFNS Spine Committee Recommendations
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    Brain and Spine.2022; 2: 101185.     CrossRef
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    International journal of health sciences.2022; 6(S10): 1816.     CrossRef
  • 25,561 View
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Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):723-736.   Published online December 31, 2020
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Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations
Neurospine. 2020;17(4):723-736.   Published online December 31, 2020
Close
Craniovertebral junction (CVJ) trauma is a challenging clinical condition. Being a highly mobile functional unit at the junction of the skull and the vertebral column, traumatic events in this area may produce devastating neurological complications and death. Additionally, many of the CVJ traumatic injuries can be left undiagnosed or even raise difficult treatment dilemmas. We present a literature review in the format of recommendations on the diagnosis and management of different scenarios for upper cervical trauma and produce recommendations, which can be applicable to various areas of the globe.

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    Marc Boutros, Guy Awad, Christèle Asmar, Jad Lawand, Antoine Mouawad, Jad Bou Monsef
    European Journal of Orthopaedic Surgery & Traumatology.2026;[Epub]     CrossRef
  • A cadaveric feasibility study of the LM-B screw as a novel posterolateral C1 lateral mass to C2 vertebral body fixation trajectory
    Bahadır Topal, Yahya Güvenç
    Scientific Reports.2026;[Epub]     CrossRef
  • Implantation choices, fusion preferences and implant removal after fixation in C1-C2 fractures: An AO Spine Knowledge Forum expert survey
    Rishi Mugesh Kanna, Mitchell Ng, Andrei F Joaquim, Gregory D Schroeder, Mohammad El-Sharkawi, Alfredo Guiroy, Ratko Yurac, Brian A Karamian, Charlotte Dandurand, Alexander R Vaccaro, Grace Xiong, Richard Bransford, Martin Holas, Klaus Schnake
    European Spine Journal.2026; 35(8): 5157.     CrossRef
  • The Utility of Bracing in Modern Spine Care
    William A. Green, Jonathan Dalton, Joshua Mathew, Gregorio Baek, Jarod Olson, Yulia Lee, Yasmine Eichbaum, Grant Thomas, Lucas Hauth, Nicholas Tomasko, Mohammed Khan, Alexander R. Vaccaro
    Contemporary Spine Surgery.2026; 27(7): 1.     CrossRef
  • Stable reduction of upper cervical spinal cord area in cervical dystonia
    Melanie Suette, Teresa Gerhalter, Thiago J.R. Rezende, Stephan Seiler, Maria Zangl, Petra Katschnig-Winter, Mariella Koegl, Johanna Mayrhofer-Grüenbühl, Christian Enzinger, Petra Schwingenschuh
    Parkinsonism & Related Disorders.2026; 150: 108417.     CrossRef
  • The establishment of a novel upper cervical complex fracture classification system
    Shangye Li, Xiulian Xu, Mingzheng Chang, Hao Li, Rongkun Xu, Wenyang Fu, Lulu Wang, Yonggang Li, Suomao Yuan, Yonghao Tian, Lianlei Wang, Xinyu Liu
    The Spine Journal.2025; 25(1): 127.     CrossRef
  • BOOTStrap-SCI: Beyond One option of treatment for spinal trauma and spinal cord injury: Consensus-based stratified protocols for pre-hospital care and emergency room (part I)
    Nicolò Marchesini, Andreas K. Demetriades, Oscar Alves, Riya Mandar Dange, Harold Mauricio Choco, Edinson Dussan Lozada, Dumar Javier Figueredo Sanabria, Angélica Gamboa, Luz Llined Mendoza Victoria, Enoc Noscue Montealegre, Jonathan A. Pardo Carranza, Jo
    Brain and Spine.2025; 5: 104251.     CrossRef
  • Prevertebral Hematoma: A Potential Biomarker for the Severity of Upper Cervical Spine Trauma and a Predictor for the Need for Surgical Intervention
    Roy Riascos, Kamand Khalaj, Elham Tavakkol, Andres Rodriguez, Jennifer McCarty, David Timaran Montenegro
    American Journal of Neuroradiology.2025; 46(9): 1943.     CrossRef
  • “Successful delayed fracture healing of a type-II odontoid fracture following posterior C1-C2 salvage fusion in an elderly patient: case report”
    Anirudh N. Eranki, Christopher M. Uchiyama
    Interdisciplinary Neurosurgery.2025; 41: 102120.     CrossRef
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    Mirza Pojskić, Miriam Bopp, Christopher Nimsky, Benjamin Saß
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    Journal of Korean Neurosurgical Society.2024; 67(1): 6.     CrossRef
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    Suzy Hall, Lucy Meehan‐Howard, Jamie Prutton
    Equine Veterinary Education.2024;[Epub]     CrossRef
  • Short-term and long-term results of odontoid screw fixation in patients with Type II and rostral Type III dens fractures
    Ivan Lvov, Andrey Grin, Aleksandr Talypov, Anton Kordonskiy, Aleksandr Tupikin
    Neurocirugía (English Edition).2024; 35(5): 233.     CrossRef
  • Short-term and long-term results of odontoid screw fixation in patients with Type II and rostral Type III dens fractures
    Ivan Lvov, Andrey Grin, Aleksandr Talypov, Anton Kordonskiy, Aleksandr Tupikin
    Neurocirugía.2024; 35(5): 233.     CrossRef
  • C1-ring оsteosynthesis as a functionally preserving operation for unstable atlas fractures
    I. V. Basankin, Abram Akopovich Giulzatyan, I. M. Magomedov, K. K. Takhmazyan, M. I. Tomina, S. B. Malakhov, A. A. Afaunov, V. A. Porkhanov
    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2024; 21(3): 6.     CrossRef
  • Pediatric Cervical Spine Trauma
    Justin K. Zhang, Natasha Hongsermeier-Graves, Boris Savic, Jeffrey Nadel, Brandon A. Sherrod, Douglas L. Brockmeyer, Rajiv R. Iyer
    Clinical Spine Surgery.2024; 37(9): 416.     CrossRef
  • C1C2 Wiring and Posttraumatic Atlantoaxial Dislocation: An Effective and Cheap Surgical Procedure in a Developing Country
    Ibrahim Dao, Massimiliano Visocchi, Salah Sow, John Jabang, Ousmane Ouattara, Astride Somda, Abdoulaye Sanou, Elie Dibloni Nassoum, Arsène Tossou, Narcisse Ouedraogo, Frédéric Bako, Massadiami Soulama, Malick Diallo, Patrick Wendpouiré Hamed Dakouré
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  • The use of a novel reduction plate in transoral anterior C1-ring osteosynthesis for unstable atlas fractures
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    Frontiers in Surgery.2023;[Epub]     CrossRef
  • Approach to upper cervical trauma
    Gomatam R. Vijay Kumar
    Indian Spine Journal.2022; 5(1): 10.     CrossRef
  • Exploring perspectives and adherence to guidelines for adult spinal trauma in low and middle-income healthcare economies: A survey on barriers and possible solutions (part I)
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    Brain and Spine.2022; 2: 100932.     CrossRef
  • Osteoporotic vertebral fractures: WFNS Spine Committee Recommendations
    Mehmet ZILELI, Maurizio FORNARI, Jutty PARTHIBAN, Salman SHARIF
    Journal of Neurosurgical Sciences.2022;[Epub]     CrossRef
  • A survey on the early management of spinal trauma in low and middle-income countries: From the scene of injury to the diagnostic phase (part II)
    Andreas K. Demetriades, Nicolò Marchesini, Oscar L. Alves, Andrés M. Rubiano, Francesco Sala
    Brain and Spine.2022; 2: 101185.     CrossRef
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  • Longitudinal atlantoaxial dislocation associated with type III odontoid fracture due to high-energy trauma. Case report and literature review
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Case Reports

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Sudden Paraplegia Caused by Nontraumatic Cervical Disc Rupture: A Case Report
Korean J Spine. 2017;14(4):155-157.   Published online December 31, 2017
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Sudden Paraplegia Caused by Nontraumatic Cervical Disc Rupture: A Case Report
Korean J Spine. 2017;14(4):155-157.   Published online December 31, 2017
Close
A 38-year-old man visited our Emergency Department for sudden onset paraplegia that occurred 1 hour ago. He felt a piercing pain in the posterior neck and became paraplegic while he was watching television, lying down on a sofa. Neurological examination showed motor power grades II-III in both arms and grade 0 in both legs. His cervical magnetic resonance imaging (MRI) showed a large ruptured disc at the C5-6 level, severely compressing the spinal cord. Emergency anterior cervical discectomy and fusion at C5-6 were performed. Because extensive cord swelling was observed on postoperative MRI, laminoplasty from C3 to C6 was performed 3 days after the initial operation. At a postoperative 8-month follow-up, the motor power was improved to grade III-IV- for both hands and grade IV- for both legs. Nontraumatic cervical disc rupture causing acute paraplegia is a very rare but possible event. Immediate neurologic assessment and thorough imaging studies to allow accurate diagnosis are crucial. Emergency surgical decompression is important and may lead to good neurological outcomes.

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  • Non-Traumatic Cervical Disc Herniation Presented as Sudden Paralysis of the Limbs: Two Case Reports
    Jeong-Ju Hong, Cheolsu Jwa, Jae Hoon Kim, Hee In Kang, In-Suk Bae, Hyungjoo Kwon
    The Nerve.2023; 9(2): 184.     CrossRef
  • 10,512 View
  • 163 Download
  • 1 Crossref

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Posttraumatic Guillain-Barré Syndrome Immediately Following a Traffic Accident
Korean J Spine. 2017;14(3):121-123.   Published online September 30, 2017
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Posttraumatic Guillain-Barré Syndrome Immediately Following a Traffic Accident
Korean J Spine. 2017;14(3):121-123.   Published online September 30, 2017
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Guillain-Barré syndrome(GBS) is an inflammatory demyelinating polyneuropathy characterized by areflexic paralysis. Most cases of GBS are preceded by an infection, however, posttraumatic GBS has also recently been reported. We report a case of posttraumatic GBS immediately following a traffic accident. We think this case is of clinical significance for practitioners because of the rare cause of a sudden flaccid paralysis following trauma.

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  • Post-Traumatic Guillain-Barre Syndrome
    Sung Ho Jo, Jongmin Lee, Jungsoo Lee, Ji Hyun Kim, Jinseok Park, Seung Hyun Kim, Ki-wook Oh
    Korean Journal of Neuromuscular Disorders.2020; 12(1): 13.     CrossRef
  • Trauma-Related Guillain–Barré Syndrome: Systematic Review of an Emerging Concept
    Chuxin Huang, Yiliu Zhang, Shuwen Deng, Yijun Ren, Wei Lu
    Frontiers in Neurology.2020;[Epub]     CrossRef
  • 9,907 View
  • 116 Download
  • 2 Crossref

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Rapid Resolution of Traumatic Pneumatocyst in the Cervical Spine: A Case Report
Korean J Spine. 2015;12(2):88-90.   Published online June 30, 2015
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Rapid Resolution of Traumatic Pneumatocyst in the Cervical Spine: A Case Report
Korean J Spine. 2015;12(2):88-90.   Published online June 30, 2015
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Intraosseous pneumatocyst is a benign, gas-filled, cystic lesion, and is commonly encountered in iliac bone or sacrum. Other locations of this lesion following trauma are rare, and only a handful of isolated cases have been reported. The pathogenesis and etiologies of this uncommon entity are various and it can present a diagnostic challenge. Only four previous cases have described the natural course of intravertebral pneumatocysts. Here, the authors report a rare case of traumatic pneumatocyst, which resolved rapidly without further complication. Possible pathogenic mechanisms are discussed and reviews of literatures are included.

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  • Vertebral Pneumatocyst in Cervical Spine CT: 2 Cases
    Min-Seop Shin, Seung-Yun Oh
    Journal of the Korean Medical Imaging.2025;[Epub]     CrossRef
  • Vertebral Pneumatocyst–A Systematic Review
    Kanwaljeet Garg, Atmaranjan Dash, Ankita Aggarwal, Stephan Duetzmann
    World Neurosurgery.2021; 151: 77.     CrossRef
  • 11,164 View
  • 80 Download
  • 2 Crossref

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Grisel's Syndrome Induced by Mycobacterium tuberculosis
Korean J Spine. 2015;12(2):84-87.   Published online June 30, 2015
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Grisel's Syndrome Induced by Mycobacterium tuberculosis
Korean J Spine. 2015;12(2):84-87.   Published online June 30, 2015
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Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joints, which is caused by an inflammatory process in the upper neck. It is rare to find literary reports of Grisel's syndrome with an evident pathogen in a lesion. For the first time in Korea, we report a 36-year-old female with Grisel's syndrome having an atlantoaxial subluxation, which was caused by a retropharyngeal abscess secondary to pulmonary Mycobacterium tuberculosis. The patient was treated with an anti-tuberculosis regimen and was prescribed a Philadelphia collar for the control of torticollis. The result of magnetic resonance imaging (MRI) showed an improved atlantoaxial alignment, after drug treatment and immobilization. This patient was neurologically intact and free from symptomatic complaints at follow-up visit. Dynamic cervical radiograph confirmed that the atlantoaxial joints had been stable. The pathophysiology of Grisel's syndrome, along with anatomical attributes, was explained on the basis of the patient's clinical course.

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  • Das Grisel-Syndrom – häufiger als gedacht?
    Jani Puhakka, Gregor Fischer, Alexander Küffer, Markus Loibl, Tamás Fekete, Dezsö Jeszenszky, Daniel Haschtmann
    Die Wirbelsäule.2025; 09(04): 203.     CrossRef
  • A case of adult-onset Grisel’s syndrome
    Ami Nakai, Masashi Uehara, Yoshinari Miyaoka, Hiroki Oba, Shota Ikegami, Takashi Takizawa, Ryo Munakata, Terue Hatakenaka, Takayuki Kamanaka, Daisuke Kurogochi, Takuma Fukuzawa, Jun Takahashi
    British Journal of Neurosurgery.2024; 38(6): 1319.     CrossRef
  • Challenges in Grisel's Syndrome Management in a Two-Month-Old Infant
    Maeen B Aldamouni, Mohammed H Albitar, Ziad H Alhosainy, Hanan N Aljohani, Essam Alshail
    Cureus.2023;[Epub]     CrossRef
  • A Case of Grisel’s Syndrome After Tonsillectomy and Adenoidectomy
    Sea Eun Yi, Yoo-Sam Chung
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2022; 65(9): 533.     CrossRef
  • Grisel's syndrome associated with mumps: A case report
    Yanrong Shen, Lixia Yang, Xiaoliang Liu, Yawen Xie, Xiaohui Dai, Chuan Wang
    Frontiers in Pediatrics.2022;[Epub]     CrossRef
  • Magnetic Resonance Imaging as the Primary Imaging Modality in Children Presenting with Inflammatory Nontraumatic Atlantoaxial Rotatory Subluxation
    Katharina J. Wenger, Elke Hattingen, Luciana Porto
    Children.2021; 8(5): 329.     CrossRef
  • Grisel's syndrome accompanying a submandibular abscess
    Onur Ismi, Hakan Ozalp, Vural Hamzaoglu, Helen Bucioglu, Yusuf Vayısoglu, Kemal Gorur
    Brazilian Journal of Otorhinolaryngology.2020; 86(5): 658.     CrossRef
  • Grisel Syndrome in Otolaryngology: A Case Series with Literature Review
    Soumyajit Das, Suvamoy Chakraborty, Subhajit Das
    Indian Journal of Otolaryngology and Head & Neck Surgery.2019; 71(S1): 66.     CrossRef
  • Grisel’s syndrome caused by Mycoplasma pneumoniae infection: a case report and review of the literature
    Raffaele Falsaperla, Gianluca Piattelli, Silvia Marino, Simona Domenica Marino, Alessandra Fontana, Piero Pavone
    Child's Nervous System.2019; 35(3): 523.     CrossRef
  • Grisel's Syndrome in an Adult After Endoscopic Nasopharyngectomy
    Andy J. K. Chua, Bernard W. S. Tan, Tiong Yong Tan, Harold H. W. Heah
    Laryngoscope Investigative Otolaryngology.2019; 4(5): 504.     CrossRef
  • Akuter Schiefhals oder Grisel-Syndrom
    B. Schulze, L. Beyer
    Manuelle Medizin.2016; 54(4): 251.     CrossRef
  • 12,313 View
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  • 11 Crossref

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Delayed Vertebral Artery Dissection after Posterior Cervical Fusion with Traumatic Cervical Instability: A Case Report
Korean J Spine. 2015;12(2):79-83.   Published online June 30, 2015
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Delayed Vertebral Artery Dissection after Posterior Cervical Fusion with Traumatic Cervical Instability: A Case Report
Korean J Spine. 2015;12(2):79-83.   Published online June 30, 2015
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Vascular injury presented immediately after the penetration, but delayed onset of vascular symptom caused by an embolism or vessel dissection after cervical fusion or traumatic event is extremely rare. We present a case of a 56-year-old woman who underwent an operation for cervical fusion for type II Odontoid process fracture. She presented symptoms of seizure with hemiparesis in 6 days after the operation. Multifocal acute infarction due to an embolism from the left VA (V3 segment) dissection was observed without a definite screw breach the transverse foramen. We hereby reported the instructive case report of delayed onset of vertebral artery dissection after posterior cervical fusion with type II odontoid process fracture patient. When a cervical operation performed in the cervical trauma patient, even if no apparent VA injury occurs before and during the operation, the surgeon must take caution not to risk cerebral infarction because of the delayed VA dissection.

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  • Iatrogenic Vascular Injury Associated with Cervical Spine Surgery: A Systematic Literature Review
    Mehmet Turgut, Ali Akhaddar, Ahmet T. Turgut, Walter A. Hall
    World Neurosurgery.2022; 159: 83.     CrossRef
  • Vascular complications in spine surgery
    Daniel B.C. Reid, Shyam A. Patel, Alan H. Daniels, Jeffrey A. Rihn
    Seminars in Spine Surgery.2019; 31(4): 100756.     CrossRef
  • Impact of Perioperative Neurologic Deficits on Clinical Outcomes After Posterior Cervical Fusion
    Sanjana Dayananda, Amol Mehta, Nitin Agarwal, Enyinna L. Nwachuku, David K. Hamilton, Parthasarathy D. Thirumala
    World Neurosurgery.2018; 119: e250.     CrossRef
  • 11,693 View
  • 102 Download
  • 3 Crossref

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Lumbar Disc Herniation in a Patient With Congenital Vertebral Body Anomaly: A Case Report
Korean J Spine. 2014;11(4):245-248.   Published online December 31, 2014
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Lumbar Disc Herniation in a Patient With Congenital Vertebral Body Anomaly: A Case Report
Korean J Spine. 2014;11(4):245-248.   Published online December 31, 2014
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Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques.

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