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
Authors: Canseco Jose A. , Schroeder Gregory D. , Patel Parthik D. , Grasso Giovanni , Chang Michael , Kandziora Frank , Vialle Emiliano N. , Oner F. Cumhur , Schnake Klaus J. , Dvorak Marcel F. , Chapman Jens R. , Benneker Lorin M. , Rajasekaran Shanmuganathan , Kepler Christopher K. , Vaccaro Alexander R. ,   AO Spine Cervical Classification Validation Group, Abdelgawaad Ahmed , Abdul Waheed , Abdulsalam Asmatullah , Abeid Mbarak , Ackshota Nissim , Acosta Olga , Akman Yunus , Aldahamsheh Osama , Alhammoud Abduljabbar , Aleixo Hugo , Alexander Hamish , Alkharsawi Mahmoud , Alsammak Wael , Amadou Hassame , Amin Mohamad , Arbatin Jose , Atan Ahmad , Athanasiou Alkinoos , Bas Paloma , Bazan Pedro , Benzakour Thami , Benzarti Sofien , Bernucci Claudiio , Bosco Aju , Butler Joseph , Castillo Alejandro , Cawley Derek , Chek Wong , Chen John , Cheng Christina , Cheung Jason , Chong Chun , Corluka Stipe , Corredor Jose , Costa Bruno , Curri Cloe , Dawoud Ahmed , Delgado-Fernandez Juan , Demiroz Serdar , Desai Ankit , Diez-Ulloa Maximo , Dimas Noe , Diniz Sara , Direito-Santos Bruno , Duerinck Johnny , El-Hewala Tarek , El-Shamly Mahmoud , El-Sharkawi Mohammed , Espinosa Guillermo , Estefan Martin , Fang Taolin , Fernandes Mauro , Fernandez Norbert , Ferreira Marcus , Figueiredo Alfredo , Fiorenza Vito , Francis Jibin , Franz Seibert , Freedman Brett , Fu Lingjie , Fuego Segundo , Gahlot Nitesh , Ganau Mario , Garcia-Pallero Maria , Garg Bhavuk , Gidvani Sandeep , Giera Bjoern , Godinho Amauri , Goni Morshed , Gonzalez Maria , Gopalakrishnan Dilip , Grin Andrey , Grozman Samuel , Gruenberg Marcel , Grundshtein Alon , Guasque Joana , Guerra Oscar , Guiroy Alfredo , Hackla Shafiq , Harris Colin , Harrop James , Hassan Waqar , Henine Amin , Hickman Zachary , Igualada Cristina , James Andrew , Jetjumnong Chumpon , Kaen Ariel , Karmacharya Balgopal , Kilincer Cumur , Klezl Zdenek , Koerner John , Konrads Christian , Krappel Ferdinand , Kruyt Moyo , Krywinski Fernando , Kundangar Raghuraj , Landriel Federico , Lindtner Richard , Linhares Daniela , Llombart-Blanco Rafael , Lopez William , Lotan Raphael , Lourido Juan , Luna Luis , Magashi Tijjani , Majer Catalin , Mandizvidza Valentine , Manilha Rui , Mannara Francisco , Margetis Konstantinos , Medina Fabrico , Milano Jeronimo , Miyakoshi Naohisa , Moisa Horatiu , Montemurro Nicola , Montoya Juan , Morais Joao , Morande Sebastian , Msuya Salim , Mubarak Mohamed , Mulbah Robert , Murugan Yuvaraja , Nacer Mansouri , Neves Nuno , Nicassio Nicola , Niemeier Thomas , Olorunsogo Mejabi , Oner F. C. , Orosco David , Ozdener Kubilay , Paez Rodolfo , Panchal Ripul , Paterakis Konstantinos , Pemovska Emilija , Pereira Paulo , Perovic Darko , Perozo Jose , Pershin Andrey , Phedy Phedy , Picazo David , Pitti Fernando , Platz Uwe , Pluderi Mauro , Ponnusamy Gunasaeelan , Popescu Eugen , Ramakrishnan Selvaraj , Ramieri Alessandro , Rebholz Brandon , Ricciadri Guillermo , Ricciardi Daniel , Robinson Yohan , Rodriguez Luis , Rogrigues-Pinto Ricardo , Romero Itati , Rosas Ronald , Russo Salvatore , Rutges Joost , Sartor Federico , Schroeder Gregory , Shariati Babak , Sharma Jeevan , Shoaib Mahmoud , Smith Sean , Sorimachi Yasunori , Sribastav Shilanant , Steiner Craig , Subbiah Jayakumar , Suramanian Panchu , Suri Tarun , Tannoury Chadi , Tokala Devi , Toluse Adetunji , Ungurean Victor , Vaccaro Alexander , Vahl Joachim , Valacco Marcelo , Valdez Cristian , Vernengo-Lezica Alejo , Veroni Andrea , Vieira Rian , Viswanadha Arun , Wagner Scott , Wamae David , Weening Alexander , Weidert Simon , Wu Wen-Tien , Wu Meng-Huang , Yuan Haifeng , Yuh Sung-Joo , Yurac Ratko , Zarate-Kalfopulos Baron , Ziabrov Alesksei , Zubairi Akbar 
Published: July 2020

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.