Treatment of Cervical Spine Fractures

  • C0
    • Stable
      • Cervical Orthosis
    • Unstable
      • C0 – C1/2 Fusion
  • Atlanto occipital dissociation
    • Powers ratio
    • Wackenheim Line
    • Beware Traction
    • Halo
    • C0 C2 fusion
  • C1 Fracture – Axial load
    • Jefferson with 4 part fracture
    • 6.8mm combined lateral mass overhang
    • Halo. Late instability = fusion
  • C1/C2 Transverse lig rupture
    • AADI >3.5 mm
    • Traction in extension followed by fusion
  • C2 Fractures
    • Dens
      • I Tip – look for C0 C1 dissociation
      • II base
        • nondisplcaed – Halo
        • Displaced – ORIF – screw or posterior fusion C1/2
      • III Metaphyseal extension
        • <6mm displacement – HALO
        • >6mm C1/2 fusion
    • Hangman
      • Type 1 <3mm – cervical orthosis
      • Type 2 >3mm – displacement – Halo