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

Webpage Last Modified: 24 September, 2011