Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    Subaxial Injury Classification and Severity Scale (SLICS)

    Classifies subaxial cervical spine injury and provides treatment recommendations.
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    INSTRUCTIONS

    May be used with x-ray or MRI.

    Pearls/Pitfalls

    MRI may show signal change in minor injuries and can lead to over-reporting of injuries (worse scores).

    No abnormality
    0
    Compression
    +1
    Burst
    +2
    Distraction (e.g. facet perch, hyperextension)
    +3
    Rotation/translation (e.g. facet dislocation, unstable teardrop or advance-stage flexion compression injury)
    +4
    Intact
    0
    Indeterminate (e.g. isolated interspinous widening, MRI signal changes only)
    +1
    Disrupted (e.g. widening of the disk space, facet perch or dislocation, kyphotic deformity)
    +2
    Intact
    0
    Root injury
    +1
    Complete cord injury
    +2
    Incomplete cord injury
    +3

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The decision for operative vs non-operative treatment in equivocal cases (i.e., SLICS = 4) should be based on clinician judgment, with shared decisionmaking as appropriate.

    Formula

    Addition of the selected points:


    Characteristic

    Points

    Morphology

    No abnormality

    0

    Compression

    1

    Burst

    2

    Distraction (e.g. facet perch, hyperextension)

    3

    Rotation/translation (e.g. facet dislocation, unstable teardrop or advance-stage flexion compression injury)

    4

    Discoligamentous complex (DLC)*

    Intact

    0

    Intermediate (e.g. isolated interspinous widening, MRI signal changes only)

    1

    Disrupted (e.g. widening of the disk space, facet perch or dislocation, kyphotic deformity)

    2

    Neurological status**

    Intact

    0

    Root injury

    1

    Complete cord injury

    2

    Incomplete cord injury

    3

    Continuous cord compression (signal change within cord on MRI) in setting of neuro deficit

    No

    0

    Yes

    1

    *As seen on x-ray or MRI.

    **By physical exam.

    Facts & Figures

    Interpretation:

    SLICS Score

    Recommendation

    <4

    Non-operative treatment

    4

    Non-operative or operative treatment

    ≥5

    Operative treatment*

    *May consist of realignment, neurological decompression (if indicated), and stabilization.

     

    Dr. Alpesh A. Patel

    About the Creator

    Alpesh A. Patel, MD, FACS, is a professor of orthopaedic surgery at Feinberg School of Medicine, Northwestern University. He is also the director of orthopaedic spine surgery at Northwestern University. Dr. Patel’s research focuses primarily on cervical spine surgery, minimally invasive spine surgery, motion preserving spine surgery, and disc replacement.

    To view Dr. Alpesh A. Patel's publications, visit PubMed

    About the Creator
    Dr. Alpesh A. Patel