Experience of surgical treatment of unstable СII vertebral fractures

CII arch fractures are divided into groups according not to anatomical localization, but to the instability degree resulted from the trauma. Effendi et al classification became greatly widespread. |t is based on the same stability criteria, but it is simpler, intelligible and gives the plan of treatment. All the fractures according to this classification are divided into three types: the first one consists in stable fractures in which even in functional images there is no any rough deformation at the level of CII segment; the second one consists in damages with significant angular (more than 11°) or shift (more than 3,5 mm) deformations, that indirectly indicates damage of soft tissue structures, and first of all diskoligamentous complex. The services of the authors of the present classification are also that they were the first who had defined fracture-dislocation of CII arch, attributed it to the third type. Choice of surgical procedure in unstable CII-III vertebral fractures is ventral spondylosyndesis of CII-III carried out by submaxillary approach after the preliminary closed elimination of deformation of upper cervical part of spine. The differentiated approach to the implant choice with an allowance for morphometric data allows to receive adequate decompression of nervous - vascular structures and reliable stabilization of the damaged segment