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Schleicher, Philipp; Kobbe, Philipp; Kandziora, Frank; Scholz, Matti; Badke, Andreas; Brakopp, Florian; Ekkerlein, Helmut; Gercek, Erol; Hartensuer, Rene; Hartung, Philipp; Jarvers, Jan-Sven; Matschke, Stefan; Morrison, Robert; Müller, Christian W; Pishnamaz, Miguel; Reinhold, Maximilian; Schmeiser, Gregor; Schnake, Klaus John; Stein, Gregor; Ullrich, Bernhard; Weiss, Thomas; Zimmermann, Volker

Treatment of Injuries to the Subaxial Cervical Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

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  • Media type: E-Article
  • Title: Treatment of Injuries to the Subaxial Cervical Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)
  • Contributor: Schleicher, Philipp; Kobbe, Philipp; Kandziora, Frank; Scholz, Matti; Badke, Andreas; Brakopp, Florian; Ekkerlein, Helmut; Gercek, Erol; Hartensuer, Rene; Hartung, Philipp; Jarvers, Jan-Sven; Matschke, Stefan; Morrison, Robert; Müller, Christian W; Pishnamaz, Miguel; Reinhold, Maximilian; Schmeiser, Gregor; Schnake, Klaus John; Stein, Gregor; Ullrich, Bernhard; Weiss, Thomas; Zimmermann, Volker
  • Published: SAGE Publications, 2018
  • Published in: Global Spine Journal, 8 (2018) 2_suppl, Seite 25S-33S
  • Language: English
  • DOI: 10.1177/2192568217745062
  • ISSN: 2192-5682; 2192-5690
  • Origination:
  • University thesis:
  • Footnote:
  • Description: <jats:sec><jats:title>Study Design:</jats:title><jats:p> Expert consensus. </jats:p></jats:sec><jats:sec><jats:title>Objectives:</jats:title><jats:p> To establish treatment recommendations for subaxial cervical spine injuries based on current literature and the knowledge of the Spine Section of the German Society for Orthopaedics and Trauma. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This recommendation summarizes the knowledge of the Spine Section of the German Society for Orthopaedics and Trauma. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> Therapeutic goals are a stable, painless cervical spine and protection against secondary neurologic damage while retaining maximum possible motion and spinal profile. The AOSpine classification for subaxial cervical injuries is recommended. The Canadian C-Spine Rule is recommended to decide on the need for imaging. Computed tomography is the favoured modality. Conventional x-ray is preserved for cases lacking a “dangerous mechanism of injury.” Magnetic resonance imaging is recommended in case of unexplained neurologic deficit, prior to closed reduction and to exclude disco-ligamentous injuries. Computed tomography angiography is recommended in high-grade facet joint injuries or in the presence of vertebra-basilar symptoms. A0-, A1- and A2-injuries are treated conservatively, but have to be monitored for progressive kyphosis. A3 injuries are operated in the majority of cases. A4- and B- and C-type injuries are treated surgically. Most injuries can be treated with anterior plate stabilization and interbody support; A4 fractures need vertebral body replacement. In certain cases, additive or pure posterior instrumentation is needed. Usually, lateral mass screws suffice. A navigation system is advised for pedicle screws from C3 to C6. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> These recommendations provide a framework for the treatment of subaxial cervical spine Injuries. They give advice about diagnostic measures and the therapeutic strategy. </jats:p></jats:sec>
  • Access State: Open Access