Traumatic cervical radicular lesions

Isolated traumatic cervical radicular lesions are rare. They constitute only 3% of the neurological lesions due to spinal trauma. A monolateral radicular lesion (Type A) is occasionally associated with medullary damage (Type B), resulting in a more complex neurological syndrome. Type A lesions are caused by flexion/rotation with fracture of the upper part of an articular facet and rotatory dislocation of the vertebra above, or by a pure monolateral dislocation. Reduction by halo traction followed by halo plaster gives good results even when the anatomical result is imperfect. Operative treatment of these lesions is required only in cases which cannot be reduced nonsurgically. Type B myelo-radicular lesions are caused by hyperextension-rotation injuries with displaced fractures of the facets and secondary subluxation. The treatment is surgical; reduction by a posterior approach with fixation by Roy-Camille plates, but must include radicular release by removal of the fractured joint mass.