Pieter L. Kubben
  1. Department of Neurosurgery, Maastricht University Medical Center, The Netherlands

Correspondence Address:
Pieter L. Kubben
Department of Neurosurgery, Maastricht University Medical Center, The Netherlands


Copyright: © 2012 Kubben PL. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

How to cite this article: Kubben PL. SLIC 2: Improved decision support for subaxial cervical spine injury. Surg Neurol Int 14-Mar-2012;3:30

How to cite this URL: Kubben PL. SLIC 2: Improved decision support for subaxial cervical spine injury. Surg Neurol Int 14-Mar-2012;3:30. Available from:

Date of Submission

Date of Acceptance

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Mobile clinical decision support systems (mCDSS) have been described to improve adherence to guidelines.[ 3 4 ] For neurosurgery, a few mCDSS are available. Surgical Neurology International offers the most downloaded neurosurgical mCDSS for free from its website, in collaboration with NeuroMind is currently available for iPhone, iPad, and Android, and offers many useful scores and some anatomical images for explanation to patients and medical students. SLIC is an app that offers evidence-based decision support for (the surgical treatment of) subaxial cervical spine injury. This app is only available for iPhone and has been developed in collaboration with Alexander Vaccaro and Marcel Dvorak.[ 1 5 ] More information on the first version of this app and its rationale has been published before in this journal.[ 2 ]


Since January 2012, the second version of SLIC has become available, and can be downloaded for free from our site (go to the “Apps” section in the menu). The app has been updated to run on iOS 5, and has got some improvements over the previous version. First, SLIC 2 runs on iPhone, iPad, and Android. Second, SLIC 2 offers more interactive features compared to the first version. The SLIC score itself can now be calculated automatically [ Figure 1 ], and the mCDSS offers advise on the type of treatment based on the score (conservative or surgery). Further, the graphical interface in the surgical decision support menu is now more user-friendly [ Figure 2 ].

Figure 1

Interactive selection and computation of the SLIC score (screenshot on Android)


Figure 2

The new menu which is more intuitive and allows easy expansion for future updates (screenshot on iPhone)



SLIC 2 shares the same programming code intelligence that is used for NeuroMind 2, which will be available soon. This allows to expand the current features of SLIC 2 to offer even more interactivity, and, for example, decision support on other spine injuries. In the “Posts” section of the menu on our site, you can go to “Information Technology” to read the latest updates on new developments. In the posts on the implementation of the surgical guidelines of the Brain Trauma Foundation, you can get an impression of what is currently possible and what is currently being developed.


1. Dvorak MF, Fisher CG, Fehlings MG, Rampersaud YR, Oner FC, Aarabi B. The surgical approach to subaxial cervical spine injuries: An evidence-based algorithm based on the SLIC classification system. Spine (Phila Pa 1976). 2007. 32: 2620-9

2. Kubben PL, van Santbrink H, Cornips EM, Vaccaro AR, Dvorak MF, van Rhijn LW. An evidence-based mobile decision support system for subaxial cervical spine injury treatment. Surg Neurol Int. 2011. 2: 32-

3. Roy P, Durieux P, Gillaizeau F, Legall C, Armand-Perroux A, Martino L. A Computerized handheld decision-support system to improve pulmonary embolism diagnosis: A randomized trial. Ann Intern Med. 2009. 151: 677-86

4. Samore MH, Bateman K, Alder SC, Hannah E, Donnelly S, Stoddard GJ. Clinical decision support and appropriateness of antimicrobial prescribing: A randomized trial. JAMA. 2005. 294: 2305-14

5. Vaccaro AR, Hulbert RJ, Patel AA, Fisher C, Dvorak M, Lehman RA. 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: 2365-74

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