The Panjabi and White criteria for spinal instability offer a structured approach to assessing the stability of the mid and lower cervical spine. Designed to integrate clinical and radiological findings, this scale assists in determining the integrity of spinal structures and the potential for injury under physiological loads.

Overview of Panjabi and White Criteria:

This scale evaluates various components, such as the condition of anterior and posterior spinal elements, the presence of a positive stretch test, spinal cord and nerve root damage, disc space abnormalities, and spinal canal dimensions. Additionally, it incorporates the anticipation of dangerous loading and findings from specific cervical spine X-rays. Points are assigned to each element based on their integrity and functionality, with higher scores indicating greater concern for instability.

Clinical Application:

Clinicians use this scale to determine the need for further intervention, which may range from conservative management to surgical stabilization. A score of 5 or more suggests potential instability, prompting careful consideration of treatment options to prevent further injury. The criteria consider not only the current damage but also potential risks, emphasizing a proactive approach to patient care.

Points System and Radiological Evaluation:

Each item on the scale is given a score, with most items contributing up to 2 points and some up to 1 point if compromised. Radiological evaluation includes two specific X-ray views of the cervical spine, with displacement or angulation beyond set thresholds significantly contributing to the total score. This objective assessment through imaging supports the clinician's judgment of spinal integrity.

In Conclusion:

The Panjabi and White criteria serve as a valuable tool in spine assessment, aiding in the identification of cervical spine instability. By quantifying damage and potential risk, it provides a framework for decision-making in the management of patients with mid and lower cervical spine concerns. The scale underscores the importance of a thorough evaluation and the implications of spinal stability on overall patient health and quality of life.