Remedy of Accidents to the Subaxial Cervical Backbone: Suggestions of the Backbone Part of the German Society for Orthopaedics and Trauma (DGOU).
International Backbone J. 2018 Sep;eight(2 Suppl):25S-33S
Authors: Schleicher P, Kobbe P, Kandziora F, Scholz M, Badke A, Brakopp F, Ekkerlein H, Gercek E, Hartensuer R, Hartung P, Jarvers JS, Matschke S, Morrison R, Müller CW, Pishnamaz M, Reinhold M, Schmeiser G, Schnake KJ, Stein G, Ullrich B, Weiss T, Zimmermann V
Examine Design: Professional consensus.
Goals: To determine remedy suggestions for subaxial cervical backbone accidents based mostly on present literature and the information of the Backbone Part of the German Society for Orthopaedics and Trauma.
Strategies: This advice summarizes the information of the Backbone Part of the German Society for Orthopaedics and Trauma.
Outcomes: Therapeutic objectives are a secure, painless cervical backbone and safety towards secondary neurologic injury whereas retaining most doable movement and spinal profile. The AOSpine classification for subaxial cervical accidents is beneficial. The Canadian C-Backbone Rule is beneficial to determine on the necessity for imaging. Computed tomography is the favoured modality. Typical x-ray is preserved for instances missing a “harmful mechanism of damage.” Magnetic resonance imaging is beneficial in case of unexplained neurologic deficit, previous to closed discount and to exclude disco-ligamentous accidents. Computed tomography angiography is beneficial in high-grade side joint accidents or within the presence of vertebra-basilar signs. A0-, A1- and A2-injuries are handled conservatively, however must be monitored for progressive kyphosis. A3 accidents are operated within the majority of instances. A4- and B- and C-type accidents are handled surgically. Most accidents might be handled with anterior plate stabilization and interbody help; A4 fractures want vertebral physique substitute. In sure instances, additive or pure posterior instrumentation is required. Often, lateral mass screws suffice. A navigation system is suggested for pedicle screws from C3 to C6.
Conclusions: These suggestions present a framework for the remedy of subaxial cervical backbone Accidents. They provide recommendation about diagnostic measures and the therapeutic technique.
PMID: 30210958 [PubMed]