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