[Surgical indications for the treatment of cervico-spinal cord injuries]

The surgical treatment of cervico-medullary traumas is indicated, in unstable lesions, in large lesions of the mobile rachidic segment in the presence of neurological complications or following worsening of prior neurological symptomatology. The purpose of the operation is at least three-fold: to obtain alignment of vertebral structures and decompression of the bone marrow due to bone or disc compression, stabilise the vertebral segment involved, attain early mobilisation of the patient. The conventional radiological examinations allows to detect osteous and artro-ligamentous lesions. The Computed Tomography shows the consequences of the lesions on the roots and the spinal cord. The Nuclear Magnetic Resonance directly shows the oedema, the haemorrhages, the compression and the section of the spinal cord. It gives useful indications for the surgical treatment of the spinal lesions. An immediate and careful assistance at the seat of the accident, during the transport and during the diagnostic steps is essential to avoid the worsening of the primitive spinal cord lesions.