[Lower cervical spine trauma: classification and operative treatment]

Area of Science:

• Orthopedics
• Neurosurgery
• Trauma Surgery

Background:

• Subaxial cervical spine (C3-7) injuries are commonly caused by traffic accidents and recreational activities.
• Accurate classification of these injuries based on stability is crucial for appropriate management.
• Neurologic deficits and patient condition significantly influence therapeutic decisions.

Purpose of the Study:

• To outline the classification and management principles for subaxial cervical spine injuries.
• To emphasize the importance of timely intervention for optimal neurologic recovery.
• To describe surgical techniques for stabilization and fusion.

Main Methods:

• Classification of cervical spine lesions using established systems (e.g., Magerl et al.).
• Assessment of injury stability, neurologic status, and accompanying conditions.
• Surgical techniques including ventral intercorporal spondylodesis, decompression, and fusion with autologous bone grafting and plate osteosynthesis.

Main Results:

• Stable injuries without neurologic deficits may be managed non-operatively with functional treatment or external immobilization.
• Unstable injuries necessitate surgical stabilization.
• Ventral intercorporal spondylodesis is effective for open reduction, decompression, and fusion in most mono- and bisegmental lesions.
• Dorsal surgery is reserved for specific cases involving spinal canal or neuroforaminal compression.

Conclusions:

• Subaxial cervical spine injury management hinges on accurate stability classification and prompt treatment.
• Ventral intercorporal spondylodesis is a reliable surgical option for stabilizing these injuries.
• Dorsal approaches are indicated in select circumstances to address persistent instability or compression.