Traumatic fractures and dislocations of subaxial cervical spine: one center results

Purpose: Traumatic injuries of the subaxial spine (C3-7) are among the most common and potentially most catastrophic injuries of axial skeleton. They occur with motor vehicle accidents in young and with falls in older population. In this study, we aimed to share our experiences with subaxial spinal injury patients surgically treated at our institution. Materials and Methods: We analyzed demographic, clinical and radiological data, surgical technique and results of 27 cases operated for traumatic fracture and dislocations of subaxial cervical spine. Subaxial Injury Classification and Severity Scale (SLICS) was used to assess severity of trauma and to guide surgical decision. Results: Mean age of the patients was 44.8 +/- 17.4 years (21 male, 6 female). Injury was due to motor vehicle accidents in nearly two-thirds, and falls in one-third of the patients. Neurologic deficits were present in 70.4% of the patients (quadriparesis/quadriplegia in 40.7%). All patients had SLIC scores of 4 or above (mean 6.9 +/- 2.0). Both anterior and posterior (12 patients), only anterior (11 patients) and only posterior (4 patients) stabilizations were performed for the instability of servical spine. During postoperative course, 18.5% of the patients had pneumonia and hospital infections and three patients (11%) died due to complications. Conclusion: Cervical spine injuries are among the important mortality and morbidity causes. Early surgical intervention for spinal cord compression and instability yields satisfactory results. Detailed preoperative clinical and radiological evaluations are required to select cases for surgical management.