{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:38:24Z","timestamp":1792730304668,"version":"4.5.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AO Spine Through the AO Spine Knowledge Forum Trauma & Infection"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross-sectional Survey-Based Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Existing classification systems for upper cervical spine trauma lack structured guidance for clinical decision-making. While the AO Spine Upper Cervical Injury Classification (UCIC) provides a comprehensive framework, it lacks an accompanying injury score. This study aimed to develop the AO Spine Upper Cervical Injury Score (UCIS) based on global perceived injury severity scores (ISS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from a global survey of 159 surgeons were analyzed. Surgeons assigned a perceived ISS (0-100) to each UCIC variable relative to the need for surgical stabilization. Median ISS values for injury morphology, neurologic status, and modifiers were translated into an integer-based scoring system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Stable Type A injuries were assigned 1 point, while unstable ligamentous and translational injuries received higher scores (eg, Type IIB = 5 points; Type IC = 7 points). For neurologic status, N0 received 0 points, N1\/N2 received 1 point, and N3\/4 were consolidated to 6 points. Unexamined patients (NX) were allocated 3 points. Modifiers M1 (nonunion risk) and M3 (comorbidities) were assigned 3 points (ISS 60.0), while M2 (instability received 4 points (ISS 75.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The AO Spine UCIS is a simplified scoring system that translates global consensus on injury severity to a clinically applicable score. It was built upon a foundational survey demonstrating minimal geographic or experiential variability in severity ratings. The UCIS serves as a clinically relevant tool to complement the validated AO Spine UCIC system and provides the necessary framework for the future development of a treatment algorithm for upper cervical spine injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261454949","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:52:54Z","timestamp":1781596374000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The AO Spine Upper Cervical Injury Score (UCIS): Development of a Consensus-Based Scoring System Based on Perceived Injury Severity Scores"],"prefix":"10.1177","author":[{"given":"Gregory D.","family":"Schroeder","sequence":"first","affiliation":[{"name":"Rothman Orthopaedic Institute at Thomas Jefferson University 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