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Osteosynthesis and Trauma Care 2003; 11(4): 166-176
DOI: 10.1055/s-2003-44856
Original Article

© Georg Thieme Verlag Stuttgart · New York

Treatment of Cervical Spine Injuries

M. Hofmeister1 , H. Jaksche2 , M. Potulski1 , V. Bühren1
  • 1Berufsgenossenschaftliche Unfallklinik, Murnau, Germany
  • 2Neurosurgery Department, Berufsgenossenschaftliche Unfallklinik, Murnau, Germany
Further Information

Publication History

Publication Date:
23 February 2004 (online)

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Abstract

Injuries to the cervical spine (CS) require differential diagnosis and effective therapy. The expected incidence of cervical spine injuries within the Federal Republic of Germany amounts to over 2 000 cases annually. The most serious complication, paraplegia as a result of damage to the cervical spinal cord, occurs in approx. 600 of these cases. Diagnosis, making indications for conservative treatment or surgery, performing technically demanding surgery - usually with special instruments - and perioperative management represent the core tasks of CS injury management, particularly with regard to the treatment of patients with cervical spinal cord injuries. In view of the incidence of secondary injuries in more than 50 % of cases and the incidence of multiple trauma in around 10 % of cases, it is imperative that patients receive treatment in a specialist trauma clinic. The objective of (surgical) treatment is to stabilise the injured motion elements securely, in conjunction with restoring normal anatomy in order to preserve function and prevent secondary neurological damage. In around 20 % of cases, immobilisation is achieved by means of cervical collars or halo fixators. Surgery is chosen in 80 % of cases. The most frequent treatment performed on the upper CS is direct screw fixation of the dens and, on the lower CS, ventral spondylodesis. Dorsal approaches with occipitocervical spondylodesis are rarely used with regard to the upper CS, and osteosynthesis with screws, plates or cerclage is rarely used on the lower CS. Access-related complications affecting the cervical viscera, nerves and vessels are rare. Neurological deterioration is rarely observed. Due to the numerous possible complications associated with the treatment of cervical spinal cord injuries, it is imperative that these patients be transferred to a clinic specialising in spine injuries as soon as possible.

Key words

Cervical spine injuries - neurological deficits associated with CS injuries - spondylodesis of the cervical spine

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Dr. Martin Hofmeister

Berufsgenossenschaftliche Unfallklinik Murnau

Prof.-Küntscher-Str. 8

82418 Murnau

Germany

Phone: +49/88 41-48-27 65

Fax: +49/88 41-48-45 12 05

Email: hofmeister@bgu-murnau.de

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