The SLICS (Sub-axial Cervical Spine Injury Classification System) was proposed to help in the decision-making of sub-axial cervical spine trauma (SCST), even though the literature assessing its safety and efficacy is scarce. Method: We compared a cohort series of patients surgically treated based on surgeon’s preference with patients treated based on the SLICS. Results: From 2009-10, 12 patients were included. The SLICS score ranged from 2 to 9 points (mean of 5.5). Two patients had the SLICS < 4 points. From 2011-13, 28 patients were included. The SLICS score ranged from 4 to 9 points (mean of 6). There was no neurological deterioration in any group. Conclusion: After using the SLICS there was a decrease in the number of patients with less severe injuries that were treated surgically. This suggests that the SLICS can be helpful in differentiating mild from severe injuries, potentially improving the results of treatment. © 2015, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.735445449Vaccaro, A.R., Hulbert, R.J., Patel, A.A., Fisher, C., Dvorak, M., Lehman, R.A., Jr., The subaxial cervical spine injury classification system: A novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex (2007) Spine (Phila Pa 1976), 32 (21), pp. 2365-2374. , http://dx.doi.org/10.1097/BRS.0b013e3181557b92Holdsworth, F., Fractures, dislocations, and fracture-dislocations of the spine (1970) J Bone Joint Surg Am, 52, pp. 1534-1551Allen, B.L., Jr., Ferguson, R.L., Lehmann, T.R., A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine (1982) Spine (Phila Pa 1976), 7, pp. 1-27Harris, J.H., Edeiken-Monroe, B., Kopansiky, D.R., A practical classification of acute cervical spine injuries (1986) Orthop Clin North Am, 17 (1), pp. 15-30Marino, R.J., Barros, T., Biering-Sorensen, F., Burns, S.P., Donovan, W.H., Graves, D.E., International standards for neurological classification of spinal cord injury (2003) J Spinal Cord Med, 26 (1), pp. 50-56Whang, P.G., Patel, A.A., Vaccaro, A.R., The development and evaluation of the subaxial injury classification scoring system for cervical spine trauma (2011) Clin Orthop Relat Res, 469, pp. 723-731. , http://dx.doi.org/10.1007/s11999-010-1576-1Magerl, F., Aebi, M., Gertzbein, S.D., Harms, J., Nazarian, S., A comprehensive classification of thoracic and lumbar injuries (1994) Eur Spine J, 3 (4), pp. 184-201. , http://dx.doi.org/10.1007/BF02221591Joaquim, A.F., Patel, A.A., Vaccaro, A.R., Cervical injuries scored according to the subaxial injury classification system: An analysis of the literature (2014) J Craniovertebr Junction Spine, 5 (2), pp. 65-70. , http://dx.doi.org/10.4103/0974-8237.139200Joaquim, A.F., Patel, A.A., Subaxial cervical spine trauma: Evaluation and surgical decision-making (2014) Global Spine J, 4 (1), pp. 63-70. , http://dx.doi.org/10.1055/s-0033-1356764Joaquim, A.F., Lawrence, B., Daubs, M., Brodke, D., Patel, A.A., Evaluation of the subaxial injury classification system (2011) J Craniovertebr Junction Spine, 2 (2), pp. 67-72. , http://dx.doi.org/10.4103/0974-8237.100057Joaquim, A.F., Ghizoni, E., Tedeschi, H., Cruz, H.Y., Patel, A.A., Clinical results of patients with subaxial cervical spine trauma treated according to the SLIC score (2013) J Spinal Cord Med, 37 (4), p. 4204. , http://dx.doi.org/10.1179/2045772313Y.0000000143