Top Papers are articles in a specific subject rated by professionals and scholars in the field. Top 10 articles are displayed in an order from the most highest rating to the lowest. In order to rate an article, one must first register at as a member.

Guidelines for the initial management and assessment of spinal injury: British Trauma Society, 2002.

Oakley P, Brohi K, Wilson A, et al.

Injury. 2003; 34: 405-425.

PMID: 12828163

These society guidelines describe initial care of suspected cervical spine injuries based on a systematic literature review.  In addition to discussing immobilization and patient handling, they present a graphic algorithm and specific recommendations for cervical spine clearance. This is an authoritative guideline for treatment of cervical injuries.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Practice Management Guidelines for the Screening of Thoracolumbar Spine Fracture.

Diaz JJ Jr, Cullinane DC, Altman DT, et al.

J Trauma. 2007; 63: 709-718.

PMID: 18073623

These practice guidelines were developed by an association committee using an EBM systematic literature review. They present a flowchart for clearance and sixteen written treatment recommendations based on the extensive existing level II and III literature. These are the best guidelines for imaging assessment of thoracic and lumbar spine trauma.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Implementation of the Canadian C-Spine Rule: prospective 12 centre cluster randomised trial.

Stiell IG, Clement CM, Grimshaw J, et al.

BMJ. 2009; 339: b4146.

PMID: 19875425


This prospective multicenter randomized trial evaluated implementation of the Canadian C-spine Rule in nearly 12,000 patients over two years. Centers implementing the rule decreased imaging by 12%, while control centers increased imaging by 12% with no difference in outcomes. This study provides evidence for a cost-saving reduction of unnecessary imaging.

Posted by on Nov 16, 2011 in Trauma | 0 comments

The Surgical Approach to Subaxial Cervical Spine Injuries: an Evidence-Based Algorithm Based on the SLIC Classification System.

Dvorak MF, Fisher CG, Fehlings MG, et al.

Spine. 2007; 32: 2620-2629.

PMID: 17978665

This systematic review by an association study group presents decision algorithms for surgical treatment of cervical spine injury. It addresses whether to operate and which approach to use with five flowcharts for different injury categories. This synthesis of the literature on cervical injuries provides a good framework for clinical decision-making.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Diagnosis and Management of Thoracolumbar Spine Fractures.

Vaccaro AR, Kim DH, Brodke DS, et al.

Instr Course Lect. 2004; 53: 359-373.

PMID: 15116627

This narrative review is an informative guide to injuries at the thoracolumbar junction. The topics include types of fractures, diagnostic evaluation, and forms of treatment. This is the best available clinical introduction specific to the thoracolumbar junction, the most frequent site of high-energy spinal injury.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, Internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery.

Reinhold M, Knop C, Beisse R, et al.

Eur Spine J. 2010; 19: 1657-1676.

PMID: 20499114

This prospective multicenter registry-like presents extensive statistics to characterize current treatment practices for thoracolumbar injury.  Most importantly, complications occurred in 14% of patients, with 5% requiring revision surgery, and another 9% had late complications during follow-up.  This paper presents a wealth of further epidemiological, surgical, and clinical data.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Traumatic Thoracic and Lumbar Spinal Fractures: Operative or Nonoperative Treatment: Comparison of Two Treatment Strategies by Means of Surgeon Equipoise.

Stadhouder A, Buskens E, de Klerk LW, et al.

Spine.  2008; 33: 1006-1017.

PMID: 18427323

This study retrospectively identified 190 of 636 patients with discordant recommendations for operative or nonoperative treatment, and then prospectively collected middle/long-term follow-up data. Both treatments were effective, with over 80% resuming employment in both groups. This paper provides reassurance that either treatment route is valid for these middle-of-the-road patients.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Pediatric Spinal Trauma: Injuries in Very Young Children.

d’Amato C.

Clin Orthop Relat Res.  2005; 432: 34-40.

PMID: 15738801

This narrative review illustrates differences in care for spinal trauma in children younger than eight years old. It covers anatomy, epidemiology, evaluation, imaging studies, occiput-C2 injuries, and neonatal injuries. This is a concise source of knowledge about these rarely described patients.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Unique Features of Pediatric Spinal Cord Injury.

Parent S, Dimar J, Dekutoski M, Roy-Beaudry M.

Spine. 2010; 35: S202-S208.

PMID: 20881463

This systematic review searched for differences between pediatric and adult spine trauma for the purpose of improving treatment recommendations. Instrumentation for instability and early bracing for deformity were supported by lower quality studies and related non-traumatic pediatric deformity literature. This paper provides guidance addressing the uncertainties of this less-studied population.


Posted by on Nov 16, 2011 in Trauma | 0 comments

Timing of surgical stabilization after cervical and thoracic trauma.

Albert TJ, Kim DH.

J Neurosurg Spine. 2005; 3: 182-190.

PMID: 16235700

This narrative review presents the evidence for and against early stabilization.  Although evidence supports both positions, the more recent literature favors early stabilization because complication rates have decreased and early surgery provides quicker mobilization and reduced morbidity. This thoughtful paper provides guidance on an important unresolved surgical issue.


Posted by on Nov 16, 2011 in Trauma | 0 comments