April 2026, Volume 4, Issue 4

Author

V Sureshkumar and M. Makesh Kumar

Abstract

Introduction: Sub axial cervical spine injuries (C3-C7) are a major cause of spinal trauma, often resulting from road traffic accidents. The Sub axial Injury Classification (SLIC) system provides a standardized framework for management based on injury morphology, disco-ligamentous complex (DLC) integrity, and neurological status. Objective: To evaluate the predictive utility of the SLIC score in determining surgical requirements and assessing its association with neurological recovery among patients with acute Sub axial cervical spine injuries. Materials and Methods: This retrospective secondary data analysis reviewed 210 patient records at a tertiary care hospital in Salem (2020-2025). SLIC scores were compared against actual treatment (operative vs. nonoperative) and neurological outcomes (ASIA grade). Results: The mean age was 45.21 years with a 69.5% male predominance, primarily due to road traffic accidents (61.0%). Surgical intervention was performed in 61.4% of patients, who had significantly higher mean total SLIC scores compared to those managed conservatively (7.64 vs. 2.98, p < 0.001). Overall, 90.9% of patients received SLIC-appropriate management. Neurological improvement was significantly higher in the surgical group (58.1%) compared to the conservative group (30.9%, p < 0.001). ROC analysis for predicting surgical requirement (SLIC > 4) demonstrated an AUC of 0.940, with 94.6% sensitivity, 85.2% specificity, and 91.0% overall accuracy. Conclusion: The SLIC score is a highly reliable predictor for surgical stabilization and demonstrates excellent diagnostic accuracy. Its strong correlation with neurological recovery and high clinical adherence supports its routine application in high-volume trauma settings.