Indication, technique and results of surgical treatment of cervical spine injuries (author's transl)

Abstract

In recent years, the surgical treatment of cervical spine injuries with initial stabilization in the acute stage has been increasingly performed with success. Drawing from a larger number of cases which we have treated in the past few years, a greater variation of deformity caused by injury has been observed. Accordingly, the surgical management has been determined by the type of deformity. Due to the anatomy of the cervical column, the injuries of the spinal cord have been divided into two basic groups for surgical management: The upper cervical - above C 3 - and the lower cervical - in the area of and below C 3. In injuries of the upper region, a dorsal stabilization is indicated, which will be varied according to the type of deformity. On the other hand, for injuries of the lower cervical region, a ventral approach with stabilization is indicated, which will also be modified according to the kind of injury. In cases of traumatic disk, axial deviation, and dislocation without fracture, a ventral fusion with external fixation will normally suffice, assuming that the patients are capable of walking and are co-operative. In cases of paraplegia, of patients who are incapable of walking, or of patients who are agitated, but above all in cases of dislocation fractures, of compression fractures, and of severe compression fractures, and internal stable ventral fixation must be performed in addition to the ventral fusion. The indication for, the technique of, and the later results of surgical treatment with follow-ups of neurological status in 66 cases having undergone surgical treatment are discussed.