Davos Courses

Executive Editor: Luiz Vialle

Subaxial cervical trauma - C

back to Spine overview

Glossary

General considerations

Type C injuries, because of the total ligamentous and or bony disruption are highly unstable lesions. Surgical treatment with fusion is indicated.

Cervicothoracic junction - posterior fixation
Main indication Skill Equipment
All C fractures at the cervico thoracic junction Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Posterior fixation alone of the cervico thoracic junction should be used with great care due to the biomechanical properties of this area.

Indications

  • All C fractures at the cervico thoracic junction

Contraindications

  • General surgical contraindications
Cervical spine - posterior fixation
Main indication Skill Equipment
All type C injuries Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications

  • All type C injuries

Contraindications

  • General surgical contraindications
Combined anterior and posterior (360)
Main indication Skill Equipment
All C fractures at the cervico thoracic junction Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications:

  • All C fractures at the cervico thoracic junction

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 type C fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications:

  • Uni- or bilateral facet joint dislocations
  • 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