STABILIZATION OF SUBAXIAL CERVICAL SPINAL-INJURIES

With subaxial cervical spine fractures, it has not been established wh ich injuries can be adequately stabilized by external orthoses and whi ch will require surgical stabilization. After review of 64 consecutive patients with C3-C-7 spinal injuries, fracture characteristics on adm ission roentgenograms were identified that accurately predict the succ ess or failure of nonoperative management. These include evidence of s evere ligamentous injury (SLI) and severe vertebral body injury (SVBI) . The presence of SLI, SVBI, or both SLI and SVBI correlated strongly with nonoperative stabilization failure (p < 0.001, p = 0.002, and p = 0.004, respectively). Injuries without SLI or SVBI were all successfu lly stabilized by cervical orthoses. Additionally, characterizing inju ries by evidence of SLI and SVBI directs the approach for surgical sta bilization.