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Upper cervical spine injuries.

R Sean Jackson1, Daxes M Banit, Alfred L Rhyne

  • 1Kansas City Bone and Joint Clinic, Kansas City, MO, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|April 20, 2004
PubMed
Summary
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Upper cervical spine injuries vary, with ligamentous tears often needing surgery. Bony fractures typically heal well without surgery, though some odontoid fractures remain debated.

Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Spine Anatomy

Background:

  • The upper cervical spine's unique anatomy predisposes it to specific injury patterns.
  • Traumatic injuries to the atlanto-occipital joint and transverse atlantal ligament are rare but serious.
  • Understanding these patterns is crucial for effective patient management.

Purpose of the Study:

  • To review the predictable injury patterns of the upper cervical spine.
  • To discuss the management strategies for various ligamentous and bony injuries.
  • To highlight areas of ongoing controversy in treatment, particularly for odontoid fractures.

Main Methods:

  • Review of anatomical considerations in upper cervical spine trauma.
  • Analysis of injury mechanisms and resulting patterns.

Related Experiment Videos

  • Discussion of current treatment modalities for ligamentous and bony injuries.
  • Examination of evidence and expert opinion on controversial fracture types.

    • Main Results:

    • Ligamentous injuries of the atlanto-occipital joint and transverse atlantal ligament are uncommon with poor healing prognosis, often requiring surgical stabilization.
    • Bony injuries such as occipital condyle fractures, atlas fractures, most odontoid fractures, and traumatic spondylolisthesis of the axis generally respond well to non-surgical management.
    • Type II odontoid fractures represent a significant area of management controversy.

    Conclusions:

    • Management of upper cervical spine injuries depends on the specific anatomical structure injured (ligamentous vs. bony).
    • Surgical intervention is often necessary for severe ligamentous injuries.
    • Non-surgical approaches are frequently successful for bony injuries, with ongoing debate for specific fracture types like type II odontoid fractures.