Early outcome of surgical intervention in subaxial cervical spine injuries

Vignesh S., Pradeep B., Balasubramanian D.


Background: Sub-axial cervical spine includes the C3 through C7 segments, a very mobile area of the spine with potential for devastating injuries as a result of instability and risk of spinal cord injury. Goal of treatment is to stabilize the spine and decompress when necessary, in order to promote the optimal environment for recovery.

Methods: This is a retrospective study of 40 patients with sub-axial cervical spine injury who underwent surgery in this institute from January 2016 to March 2017.

Results: Most of the patients were young males with road traffic accident. They underwent cerival traction for reducing translation and surgical management, mostly anterior procedures and in some cases posterior stabilisation.

Conclusions: Most of the subaxial spine injuries can be treated by anterior procedures. Preoperative neurological status is an important predictor in postoperative neurological improvement.


Anterior approach, Subaxial cervical spine trauma, Surgical management

Full Text:



Hong R, Meenan M, Prince E, Murphy R, Tambussi C, Rohrbach R, et al. Comparison of three prehospital cervical spine protocols for missed injuries. West J Emerg Med. 2014;15:471-9.

Hu R, Mustard CA, Burns C. Epidemiology of incident spinal fracture in a complete population. Spine. 1996;21:492-9.

Torretti JA, Sengupta DK. Cervical spine trauma. Indian J Orthop. 2007;41:255-67.

Harris MB, Reichmann WM, Bono CM, Bouchard K, William MR, Christopher MB, et al. Mortality in elderly patients after cervical spine fractures. J Bone Joint Surg Am. 2010;92:567-74.

Fisher CG, Noonan VK, Dvorak MF. Changing face of spine trauma care in North America. Spine. 2006;31(suppl):S2-8.

American Association of Neurological Surgeons. Treatment of subaxial cervical spinal injuries. Neurosurg. 2002;50(3):S156-65.

Blauth M, Schmidt U, Bastia L, Knop C, Tscherne H. Anterior interbody fusion for cervical spine injuries-indications, implants, technique and results. Zentralbl Chir. 1998;123:919-29.

Elsaghir H, Bohm H. Anterior versus posterior cervical plating in cervical corpectomy. Arch Orthop Trauma Surg. 2000;120:549-54.

Denaro V, Martino AD. Cervical Spine Surgery: An Historical Perspective. Clin Orthop Relat Res. 2011;469:639-48.

Reindl R, Ouellet J, Harvey EJ, Berry G, Arlet V. Anterior reduction for cervical spine dislocation. Spine. 2006;31:648-52.

Koller H, Reynolds J, Zenner J, Forstner R, Hempfing A, Maislinger I, et al. Mid to long term outcome of instrumented anterior cervical fusion for subaxial injuries. Eur Spine J. 2009;18:630-53.

Aebi M. Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures. Eur Spine J. 2010;19:33-9.

Koivikko MP, Myllynen P, Santavirta S. Fracture dislocations of the cervical spine: a review of 106 conservatively and operatively treated patients. Eur Spine J. 2004;13:610-6.

Fehlings MG, Vaccaro A, Wilson JR, Singh AW, Cadotte D, Harrop JS, et al. Early versus Delayed Decompression for Traumatic Cervical Spinal Cord Injury: Results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS ONE. 2012;7(2):e32037.

Satar A, Wazir Z, Muhammad S, Mohammad A, Mohammad I. Early outcome of surgical intervention in subaxial cervical spine injuries. JPMA. 2014;64(2):S-83.