Surgical stabilization of the cervical spine after trauma

Surgical stabilization should be individualized for each patient. The procedure used should provide both immediate and prolonged stability at the site of instability. The choice of procedure depends on knowledge of the structures providing stability and of the mechanism of injury. Pure flexon injuries without comminution or disruption of ligaments are stable and do not require surgical treatment. Flexion-rotation dislocations, with either unilateral or bilateral facet dislocation, should be treated by posterior open reduction and fusion if they cannot be reduced by a closed method or if there is demonstratable motion on three-month flexion-extension roentgenograms. A comminuted burst ("teardrop") fracture produced by axial loading of the vertebral bodies should be stabilized by an anterior cortical strut graft for early mobilization and realignment of the spinal column to prevent progressive deformity.