Executive Editor: Luiz Vialle

Subaxial cervical trauma - B2

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Glossary

General considerations

Type B2 injuries are posterior bone and/or ligament disruptions, in general associated with an A-type fracture, creating severe instability. Surgical treatment is recommended with fusion.

These injuries are usually associated with facet injuries.

Cervicothoracic junction - posterior fixation
Main indication Skill Equipment
Pure posterior ligamentous injures, facet injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications

  • Pure posterior ligamentous injuries
  • Facet fractures

Contraindications

  • Severe associated A3 or A4 injuries
Cervical spine - posterior fixation
Main indication Skill Equipment
Pure posterior ligamentous injures, facet injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications

  • Pure posterior ligamentous injuries
  • Facet fractures

Contraindications

  • Severe associated A3 or A4 injuries
Combined anterior and posterior (360)
Main indication Skill Equipment
B2 fractures at the cervico thoracic junction; spinal cord compression Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications:

  • All B2 fractures at the cervico thoracic junction
  • spinal cord compression

The cervicothoracic junction is biomechanically different from the subaxial cervical spine. In this region the mechanical stress on any implant will be significantly greater than in the subaxial cervical spine. To ensure adequate stabilization, the lesion should be instrumented both anterior and posterior (360° procedure).

Anterior plating
Main indication Skill Equipment
All B2 fractures; polytrauma; SCI Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications:

  • All B2 fractures
  • Polytrauma
  • Spinal cord injury

Contraindications

  • General surgical contraindications

Anterior fixation of the cervicothoracic junction should be supplemented by a posterior fixation.

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources