The AO Spine Upper Cervical Injury Score (UCIS): Development of a Consensus-Based Scoring System Based on Perceived Injury Severity Scores.
Publication/Presentation Date
6-16-2026
Abstract
Study DesignCross-sectional Survey-Based Study.ObjectivesExisting classification systems for upper cervical spine trauma lack structured guidance for clinical decision-making. While the AO Spine Upper Cervical Injury Classification (UCIC) provides a comprehensive framework, it lacks an accompanying injury score. This study aimed to develop the AO Spine Upper Cervical Injury Score (UCIS) based on global perceived injury severity scores (ISS).MethodsData from a global survey of 159 surgeons were analyzed. Surgeons assigned a perceived ISS (0-100) to each UCIC variable relative to the need for surgical stabilization. Median ISS values for injury morphology, neurologic status, and modifiers were translated into an integer-based scoring system.ResultsStable Type A injuries were assigned 1 point, while unstable ligamentous and translational injuries received higher scores (eg, Type IIB = 5 points; Type IC = 7 points). For neurologic status, N0 received 0 points, N1/N2 received 1 point, and N3/4 were consolidated to 6 points. Unexamined patients (NX) were allocated 3 points. Modifiers M1 (nonunion risk) and M3 (comorbidities) were assigned 3 points (ISS 60.0), while M2 (instability received 4 points (ISS 75.0).ConclusionThe AO Spine UCIS is a simplified scoring system that translates global consensus on injury severity to a clinically applicable score. It was built upon a foundational survey demonstrating minimal geographic or experiential variability in severity ratings. The UCIS serves as a clinically relevant tool to complement the validated AO Spine UCIC system and provides the necessary framework for the future development of a treatment algorithm for upper cervical spine injuries.
First Page
21925682261454949
Last Page
21925682261454949
ISSN
2192-5682
Published In/Presented At
Schroeder, G. D., Dalton, J., Ng, M. K., Schnake, K., Bransford, R., Chhabra, H. S., El-Sharkawi, M., Bigdon, S., Joaquim, A., Vaccaro, A. R., & AO Spine Upper Cervical Classification International Validation Members (2026). The AO Spine Upper Cervical Injury Score (UCIS): Development of a Consensus-Based Scoring System Based on Perceived Injury Severity Scores. Global spine journal, 21925682261454949. Advance online publication. https://doi.org/10.1177/21925682261454949
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
42299462
Department(s)
Administration and Leadership
Document Type
Article