Posterior stabilization of subaxial cervical spine trauma: indications and techniques

Current techniques for posterior cervical spine stabilization following trauma include spinous process or facet wiring [1-9], lateral mass plating [10-18], and cervical pedicle screws [19-27]. Several radiological tools, including MRI [28] and reformatted CT, yield precise details of the injured spine and allow the treating physician to determine which, if any, fixation technique offers the best chance of recovery with the least amount of risk. The goals of surgery following acute cervical spine injury include decompressing the injured spinal cord or nerve root, maintaining alignment, providing stability to the spine, promoting healing and fusion, and allowing early mobilization. This article will review indications for posterior cervical spine surgery, as well as the techniques that are currently available to help achieve the above-noted goals. We also report a recent retrospective review of 5-year data in treating posterior cervical trauma with lateral mass and pedicle screw fixation.