[Lower cervical spine trauma: classification and operative treatment].
Injuries to the subaxial cervical spine (C3-7) occur mostly from traffic accidents and in recreational activities. Such lesions that appear on roentgenological or magnetic resonance images must be classified according to stability. Neurologic deficits, accompanying injuries, and the patient's general condition play major roles in the choice of therapy. Fracture and fracture dislocations should be reduced as soon as possible, as neurologic regeneration and successful reduction are closely time related. The classification developed by Magerl et al. for thoracic and lumbar spine can also be used for the lower cervical spine. Stable injuries without neurologic deficits can generally be treated functionally and, sometimes, with external immobilization. Unstable injuries should be stabilized and treated surgically. Ventral intercorporal spondylodesis is a proven, standard surgical technique for open reduction, decompression, and fusion. Disc and whole or partial vertebral resection along with intercorporal fusion with autologous iliac crest bone grafting and plate osteosynthesis enables successful stabilization of almost all mono- and bisegmental lesions. Dorsal surgery is indicated only in case of a compressed spinal canal and/or neuroforamens due to destroyed posterior elements or remaining instability following ventral plate spondylesis.
Reinhold
M
M
Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Medizinische Universität Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. maximilian.reinhold@uklibk.ac.at
Blauth
M
M
Rosiek
R
R
Knop
C
C
D000063:Accidents, Traffic; D000328:Adult; D000367:Age Factors; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D018849:Controlled Clinical Trials as Topic; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D016103:Spinal Fractures / Q000145:classification / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D013123:Spinal Fusion / Q000379:methods; D013124:Spinal Injuries / Q000145:classification / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D014911:Whiplash Injuries / Q000175:diagnosis