Regional and experiential differences in surgeon preference for the treatment of cervical facet injuries: a case study survey with the AO Spine Cervical Classification Validation Group
José A. Canseco, Gregory D. Schroeder, Parthik D. Patel, Giovanni Grasso, Michael Chang, Frank Kandziora, Emiliano Vialle, F. Cumhur Öner, Klaus John Schnake, Marcel F. Dvorak, Jens R. Chapman, Lorin M. Benneker, Shanmuganathan Rajasekaran, Christopher K. Kepler, Alexander R. Vaccaro, AO Spine Cervical Classification Validation Group, Ahmed Shawky Abdelgawaad, Waheed Abdul, Asmatullah Abdulsalam, Mbarak Abeid, Nissim Ackshota, Olga Lucía Acosta, Yunus Emre Akman, Osama Aldahamsheh, Abduljabbar Alhammoud, Hugo Aleixo, Hamish Alexander, Mahmoud Alkharsawi, Wael Alsammak, Hassame Amadou, Mohamad Amin, Jose Joefrey F. Arbatin, Ahmad Atan, Alkinoos Athanasiou, Paloma Bas, Pedro Luis Bazán, Thami Benzakour, Sofien Benzarti, Claudiio Bernucci, Aju Bosco, Joseph S. Butler, Alejandro Castillo, Derek T. Cawley, Wong Chek, John Chen, Christina W. Cheng, Jason Pui Yin Cheung, Chun Wie Chong, Stipe Ćorluka, Jose Alfredo Corredor, Bruno R. da Costa, Cloe Curri, Ahmed Dawoud, Juan Delgado-Fernández, Serdar Demiroz, Ankit Desai, Maximo Diez-Ulloa, Noe Dimas, Sara Diniz, Bruno Direito-Santos, Johnny Duerinck, Tarek Elhewala, Mahmoud El-Shamly, Mohammed Elsharkawi, Guillermo José López Espinosa, Martín Estefan, Taolin Fang, Mauro Antonio Fernandes, Norbert Fernandez, Marcus Castro Ferreira, Alfredo Figueiredo, Vito Fiorenza, Jibin Francis, Seibert Franz, Brett A. Freedman, Lingjie Fu, Segundo Fuego, Nitesh Gahlot, Mario Ganau, Maria Garcia-Pallero, Bhavuk Garg, Sandeep Gidvani, Bjoern Giera, Amauri Godinho, M M Goni, María Mateos González, Dilip Gopalakrishnan, А. А. Grin, Samuel Grozman, Marcel Gruenberg, Alon Grundshtein, Joana Guasque, Oscar Guerra, Alfredo Guiroy, Shafiq Hackla, Colin Harris, James S. Harrop, Waqar Hassan, Amin Henine, Zachary L. Hickman
Abstract
PURPOSE: The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon's geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. METHODS: A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. RESULTS: A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. CONCLUSION: More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.