Subaxial Cervical and Cervicothoracic Spine Fractures and Dislocations

Abstract

Fractures and dislocations of the subaxial cervical spine and cervicothoracicjunction are common and potentially devastating injuries. Depending on the severity of injury, outcomes range from full recovery to varying degrees of temporary or permanent incomplete or complete neurologic compromise to death. The most common surgical techniques employed in treating these injuries are anterior cervical diskectomy and instrumented fusion, anterior cervical corpectomy with interbody strut graft placement and instrumented fusion, posterior spinal fusion with or without instrumentation, and anterior or posterior iliac crest bone grafting. Treatment decisions are typically based on an understanding of the injury mechanism, degree of biomechanical instability, neurologic status of the patient, and individual patient factors. A better understanding of the epidemiology, diagnosis, classification, treatment options, and complications of these life-threatening injuries will allow the practicing clinician to maintain a high index of suspicion and appropriately manage patients.

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