Clinical Correlations to Specific Phenotypes and Measurements With Classification Systems

Trauma to the upper cervical spine can result in a spectrum of pathology, ranging from benign to catastrophic. Upper cervical spine fractures account for nearly 70% of all cervical injuries in elderly adults and more than 35% of cervical injuries in young adults resulting in significant neurologic damage, chronic pain, and serious disability (Daffner et al., 1998). Proper diagnosis, stabilization, and definitive management of upper cervical spine injuries are critical to avoid short- and long-term mortality and morbidity. Over the last several decades, numerous classification schemes have been developed to assist clinicians and surgeons in proper medical and surgical decision-making. This chapter aims (1) to present the various classification systems for describing upper cervical spine injuries, (2) to discuss the clinical correlates associated with each classification, specifically management of upper cervical spine injuries, and (3) to critique the classification based upon literature review.