Current concepts in management of cervical spine fractures and dislocations

In order to manage the patient with a cervical spine injury, one must be familiar with a diagnostic classification of these injuries and be able to apply this classification to the individual patient. When a cooperative effort is made between orthopedists and neurosurgeons, we have found that most cervical spine injuries can be managed successfully without operative means using Cheshire's classification for predicting late instability. We have been able to identify (1) those patients who would not substantially benefit from surgical intervention; (2) certain types of injuries where relative indications for surgery may be considered; and (3) we have confirmed the danger and risk of early operative intervention following cervical spine trauma in the neurologically damaged spinal cord.