Treatment of Subaxial Cervical Spinal Injuries
Publication Date: March 1, 2013
Last Updated: March 14, 2022
RECOMMENDATIONS
Closed or open reduction of subaxial cervical fractures or dislocations is recommended. Decompression of the spinal cord/restoration of the spinal canal is the goal.
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Stable immobilization by either internal fixation or external immobilization to allow for early patient mobilization and rehabilitation is recommended. If surgical treatment is considered, either anterior or posterior fixation and fusion is acceptable in patients not requiring a particular surgical approach for decompression of the spinal cord.
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Treatment of subaxial cervical fractures and dislocations with prolonged bed rest in traction is recommended if more contemporary treatment options are not available.
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The routine use of computed tomography and magnetic resonance imaging of trauma victims with ankylosing spondylitis is recommended, even after minor trauma.
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For patients with ankylosing spondylitis who require surgical stabilization, posterior longsegment instrumentation and fusion or a combined dorsal and anterior procedure is recommended. Anterior standalone instrumentation and fusion procedures are associated with a failure rate of up to 50% in these patients.
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Recommendation Grading
Overview
Title
Treatment of Subaxial Cervical Spinal Injuries
Authoring Organization
Congress of Neurological Surgeons
Endorsing Organization
American Association of Neurological Surgeons
Publication Month/Year
March 1, 2013
Last Updated Month/Year
January 10, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult
Health Care Settings
Ambulatory, Hospital
Intended Users
Physician, nurse, nurse practitioner, physician assistant
Scope
Management, Treatment
Diseases/Conditions (MeSH)
D013167 - Spondylitis, Ankylosing, D002574 - Cervical Vertebrae, D013124 - Spinal Injuries
Keywords
ankylosing spondylitis, Anterior, Posterior stabilization, fusion procedures, subaxial cervical fracture, spinal injuries, cervical vertebrae