# SLIC — Subaxial cervical spine Injury Classification and severity scale

> Scores injury morphology, discoligamentous complex integrity, and neurologic status to grade subaxial cervical spine trauma and guide operative versus nonoperative management.

**Situação:** vigente · **Órgão:** Coluna · **Órgão emissor:** Spine Trauma Study Group · **Versão:** 2007 · **Ano:** 2007

## Procedência e vigência
- Família: léxico
- Tipo de lógica: score
- Modalidade: CT, MRI
- Fonte primária: Vaccaro AR, Hulbert RJ, Patel AA, et al.; Spine Trauma Study Group. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex (2007) — https://pubmed.ncbi.nlm.nih.gov/17906580/
- Última verificação: 2026-07-24
- Última checagem: 2026-07-24

## Lógica de decisão
Return every component and modifier instead of only the total. Keep score 4 explicitly equivocal and never infer the neurologic examination from CT or MRI.

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| <=3 | Nonoperative (3 or less) | Total SLIC score of 0-3 for an acute subaxial cervical injury after adding the highest-severity morphology (0-4), discoligamentous-complex integrity (0-2), neurologic status (0-3), and the +1 persistent-cord-compression modifier when applicable. | The SLIC authors support nonoperative management for scores of 3 or less. This is a recommendation band rather than an automatic disposition; neurologic trajectory, confounders, comorbidities, patient preference and treating-spine-team judgment still apply. | Lower SLIC severity band. The score conveys relative injury severity and treatment guidance but is not a calibrated probability of instability, neurologic decline or failure of nonoperative care. | Vaccaro et al., Spine 2007, PMID 17906580 and DOI 10.1097/BRS.0b013e3181557b92, original score and treatment thresholds; Whang et al., PMC3032869, Table 2 and treatment recommendations; SLICS summary PMC7491911, Table 2. | ✓ |
| 4 | Equivocal (4) | Total SLIC score of exactly 4 from the same morphology, discoligamentous-complex and neurologic components, including the cord-compression modifier when it applies. | Intentionally equivocal: either nonoperative or operative management may be appropriate. The decision must integrate the exact component pattern, neurologic findings, confounders, patient preference, comorbidity and surgeon judgment rather than rounding the score into an adjacent band. | Indeterminate treatment-guidance band. Different component combinations can produce the same total, so the number alone does not quantify an individual adverse-event probability. | Whang et al., PMC3032869, treatment-threshold discussion; SLICS summary PMC7491911, Table 2 and text: score 4 is indeterminate and requires treating-surgeon discretion. | ✓ |
| >=5 | Operative (5 or more) | Total SLIC score of 5-10 from the complete component sum. Higher totals are driven by distraction or rotation/translation morphology, disrupted discoligamentous complex, neurologic injury, and/or persistent cord compression with deficit. | The SLIC authors support operative management for scores of 5 or more. The total does not independently select an approach, levels, decompression or construct; those require the injury pattern, neurologic status, patient factors and specialist judgment. | Higher SLIC severity band and stronger author support for operative treatment, but not a calibrated individual probability of instability, neurologic outcome, morbidity or surgical benefit. | Vaccaro et al., Spine 2007, PMID 17906580, original threshold-based treatment guidance; Whang et al., PMC3032869, Table 2 and treatment discussion; SLICS summary PMC7491911. | ✓ |

### Citações por categoria
- **<=3**: Vaccaro AR, Hulbert RJ, Patel AA, et al.; Spine Trauma Study Group. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex (2007) — https://pubmed.ncbi.nlm.nih.gov/17906580/ · Vaccaro et al., Spine 2007, PMID 17906580 and DOI 10.1097/BRS.0b013e3181557b92, original score and treatment thresholds; Whang et al., PMC3032869, Table 2 and treatment recommendations; SLICS summary PMC7491911, Table 2.
- **4**: Vaccaro AR, Hulbert RJ, Patel AA, et al.; Spine Trauma Study Group. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex (2007) — https://pubmed.ncbi.nlm.nih.gov/17906580/ · Whang et al., PMC3032869, treatment-threshold discussion; SLICS summary PMC7491911, Table 2 and text: score 4 is indeterminate and requires treating-surgeon discretion.
- **>=5**: Vaccaro AR, Hulbert RJ, Patel AA, et al.; Spine Trauma Study Group. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex (2007) — https://pubmed.ncbi.nlm.nih.gov/17906580/ · Vaccaro et al., Spine 2007, PMID 17906580, original threshold-based treatment guidance; Whang et al., PMC3032869, Table 2 and treatment discussion; SLICS summary PMC7491911.

## Referências cruzadas
- _fronteira compartilhada_ → [Anderson-D'Alonzo — Anderson and D'Alonzo classification of odontoid fractures](https://radcommons.laudos.ai/systems/anderson-dalonzo.md) — Cervical trauma systems: Anderson-D'Alonzo classifies odontoid (C2) fractures, SLIC scores subaxial (C3-C7) injuries.
- _fronteira compartilhada_ → [TLICS — Thoracolumbar Injury Classification and Severity score](https://radcommons.laudos.ai/systems/tlics.md) — SLIC adapts the TLICS framework (morphology, ligamentous/neural status, severity score) to the subaxial cervical spine.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2007-09-01 | published | Subaxial cervical spine injury classification published in Spine. | confirmed |


---
> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

Página HTML: https://radcommons.laudos.ai/systems/slic · JSON da API: https://radcommons.laudos.ai/api/v1/systems/slic · Índice para agentes: https://radcommons.laudos.ai/llms.txt