Subaxial Vertebral Body Fracture  

Classification (SLICS) 

• Morphology, DLC, neuro 
• 4 is the midpoint (above 4 is surgery) 
• Morphology 
  • None 
  • Compression 1 
  • Burst 2 
  • Distraction 3  
  • Rotation/ Translation 4 
• PLC 
  • Intact 
  • Indeterminate 1 
  • Disrupted 2 
• Neuro 
  • Intact 0 
  • Root 1 
  • Complete2 
  • Incomplete 3 
  • Ongoing compression 4 

Studies 

• 3 NASCIS studies – steroids 
  • Lack of clear evidence supporting neurological improvement 
• Early decompression <24h for SCI shows improved chances of conversion 

AO Classification 

• A – compression 
• B – tension band 
• C – translation 
• F facet 

Types and Management 

• Compression 
  • Compression of body 
  • Management 
    • PLC intact – Collar 3 months then flex ex 
    • PLC violated, neuro deficit, kyphosis <11 
      • Anterior or Posterior stabilization 
• Burst 
  • Compression + retropulsion 
  • Management 
    • PLC intact, no neuro 
      • Collar3 months 
    • Neuro 
      • Anterior corpectomy and fusion 
• Flexion teardrop 
  • Quadrangular anterior fragment 
  • Anterior column fails in flexion 
  • Posterior in tension 
  • Associated SCI 
  • Management 
    • Anterior corpectomy and fusion 
• Extension teardrop 
  • Confused with flexion teardrop 
  • Typically C2 
  • Small fleck of bone from anterior endplate 
  • Associated Central Cord Syndrmome 
  • Management 
    • Usually stable usually no SCI 

Stable 

• <25 height loss 
• <13 kyphosis