Management of Trauma to the Upper Cervical Spine: Occiput to C2

Abstract

Trauma to the upper cervical spine occurs in various patterns of injury, including atlanto-occipital dislocations, atlantoaxial rotatory subluxations, fractures of the atlas or odontoid, and hangman's fractures. All of these patterns of injury can be associated with substantial morbidity and mortality. The management of patients who have sustained trauma to the upper cervical spine is guided by a set of basic principles. However, the ultimate strategies for managing these patients vary with the pattern and subtype of injury. Considering the potentially devastating outcomes associated with trauma to the upper cervical spine, it is essential that all patients sustaining such trauma be given appropriate, evidence-based care. Further research and information obtained from prospective clinical trials are needed to reach more definitive conclusions about optimal treatment protocols, based on various patient-specific factors, for different patterns of injury to the upper cervical spine.

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