Bühren V, Hofmeister M, Militz M, Potulski M
Berufsgenossenschaftliche Unfallklinik Murnau.
Zentralbl Chir. 1998;123(8):907-13.
The indication for operative treatment of serious injuries to the cervical spine is basically determinated by instability and dislocation. Timing of the operation is based on the neurological deficit. If there is a chance for recovery operative treatment is urgent. For the upper cervical spine defined indications are existing for type-2-fractures of the dens and C 2/C 3-instabilities of the hangman-type with major dislocation. Fractures of C 0 and C 1 are preferably treated by conservative methods. Only cases with compound injury patterns with a high degree of ligamentous instability may require dorsal fusion. For serious injuries of the lower cervical spine operative treatment is needed in most instances. Conservative treatment is only indicated if functional stability can be proofed and injuries to the discs and compression to the myelon are ruled out.
颈椎严重损伤的手术治疗指征基本由不稳定性和脱位决定。手术时机基于神经功能缺损情况。如果存在恢复的机会，手术治疗则较为紧急。对于上颈椎，明确的手术指征包括齿状突2型骨折以及伴有严重脱位的绞刑者型C2/C3不稳。C0和C1骨折最好采用保守治疗方法。只有伴有高度韧带不稳定的复合损伤模式的病例可能需要后路融合术。对于下颈椎的严重损伤，大多数情况下需要进行手术治疗。只有在能够证明功能稳定且排除椎间盘损伤和脊髓受压的情况下才考虑保守治疗。
