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Subaxial Injury Classification and Severity Scale (SLIC)

Guides operative versus non-operative management of subaxial (C3-C7) cervical spine trauma.

Subaxial Injury Classification and Severity Scale (SLIC)
Injury morphology
Disco-ligamentous complex (DLC) integrity
Neurologic status
Result0 points

Non-operative management

Suggested management
Non-operative management

When to use

  • Classifying subaxial (C3-C7) cervical spine trauma to guide the decision between non-operative and operative management.

Formula

SLIC = Morphology (0-4) + disco-ligamentous complex integrity (0-2) + neurologic status (0-4). Score <=3 favours non-operative treatment, 4 is indeterminate, >=5 favours operative treatment.

Pearls and pitfalls

  • Emphasises injury morphology, ligamentous integrity, and neurologic status rather than a purely mechanistic (bony) classification.

References

  1. Vaccaro AR, Hulbert RJ, Patel AA, et al. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 2007;32(21):2365-74.