[Injuries of the cervical spine--surgical therapy]

Surgical treatment of unstable cervical spine injuries has justifiably gained acceptance when based on definite indications and methods of internal fixation. Direct anterior screw fixation of the odontoid process is the appropriate procedure for stabilizing articulation fractures. Many instability problems of the upper cervical spine can be solved with posterior transarticular fixation C1/C2 according to Magerl. Of the posterior procedures for the lower cervical spine, hook-plate fixation according to Magerl is preferable to wirings. Plate fixation with hollow titanium screws (Morscher) has proved a successful anterior procedure. The two methods can be combined to treat severe osteoligamentous injuries.