Subaxial Injury Classification and Severity Scale (SLICS)
SLICS Calculator
Morphology
Disco-Ligamentous Complex (DLC)
Neurological Status
SLICS Score:
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Classifies subaxial cervical spine injury and provides treatment recommendations.
Formula
Addition of the selected points: Characteristic Points Morphology No abnormality 0 Compression 1 Burst 2 Distraction (e.g. facet perch, hyperextension) 3 Rotation/translation (e.g. facet dislocation, unstable teardrop or advance-stage flexion compression injury) 4 Discoligamentous complex (DLC)* Intact 0 Intermediate (e.g. isolated interspinous widening, MRI signal changes only) 1 Disrupted (e.g. widening of the disk space, facet perch or dislocation, kyphotic deformity) 2 Neurological status** Intact 0 Root injury 1 Complete cord injury 2 Incomplete cord injury 3 Continuous cord compression (signal change within cord on MRI) in setting of neuro deficit No 0 Yes 1 *As seen on x-ray or MRI. **By physical exam.
Pearls / Pitfalls
MRI may show signal change in minor injuries and can lead to over-reporting of injuries (worse scores).
Advice
The decision for operative vs non-operative treatment in equivocal cases (i.e., SLICS = 4) should be based on clinician judgment, with shared decisionmaking as appropriate.
More Information
Interpretation: SLICS Score Recommendation <4 Non-operative treatment 4 Non-operative or operative treatment ≥5 Operative treatment* *May consist of realignment, neurological decompression (if indicated), and stabilization.