Controversial cervical spine fractures: Classification and treatment

Cervical spine fractures remain a major source of morbidity and mortality but the treatment of many fractures is controversial. Recent studies have demonstrated that surgical treatment of many type II odontoid fractures leads to decreased morbidity and mortality. Controversy still remains about the treatment of C1 fractures, but the specific injury to the alar ligament can be helpful in guiding treatment. Subaxial cervical spine injury classification systems assess which injuries require surgery. These systems suggest burst fractures with neurologic deficits should be managed surgically, whereas those that lack neurologic symptoms and have an intact disco-ligamentous complex heal with orthotic treatment.