Fractures of the cervical spine

Abstract

OBJECTIVES:The aim of this study was to review the literature on cervical spine fractures.METHODS:The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed.RESULTS:Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures.CONCLUSIONS:Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

Incidence and Features of Vertebral Fractures After Scalp Avulsion Injuries

“…13 In the lower cervical spine, the Subaxial Injury Classification (SLIC) has been widely used to predict the prognosis, taking into consideration the morphology, neurological status and the integrity of the disc-ligament-complex. 14 Owing to its anatomical location, the axis receives most of the vertical load, which is transmitted in an anterior direction towards the disc space. 15 Force vectors pass downwards and diverge at the level of the axis.…”

Trauma der Wirbelsäule: erste Hilfe durch Schnittbildverfahren

“…Anders als bei dem CT-gestütz-ten System von Denis ist für die Diagnose die Magnetresonanztomographie (MRT) wichtig. Diese Klassifikationen sind seit Jahren dabei, sich klinisch durchzusetzen [17,21].…”

Subaxial Cervical Fracture: Application and Correlation of Ao and Slic

“…The use of methylprednisolone at high doses, previously advocated based on the NASCIS 3 studies, has been abandoned by several institutions due to the lack of scientific evidence providing grounds for its use, and the high rate of complications resulting from the adverse effects of corticoids. Based on current evidence, this recommendation cannot, therefore, be made, 4,5 and the orthopedic surgical or nonsurgical treatment of cervical fractures continues to be the central focus in these patients, while the decision regarding the type of treatment, and the method, is still discussed among professionals today.…”