A comprehensive narrative review of subaxial cervical spine injuries (C3–C7), covering epidemiology, anatomy, biomechanics, classification, and management. It addresses how to evaluate mechanical instability and neurologic status to guide surgical versus nonsurgical decisions, and examines ongoing controversies around closed reduction and methylprednisolone use.
When you see any subaxial cervical injury, structure your decision-making around three questions: Is it mechanically unstable? Is there neurologic compromise needing decompression? Are there patient factors (AS, DISH, obesity) that change the plan? When you see a patient with AS or DISH and even a low-energy fall, treat the cervical spine like a fractured long bone — these injuries are extremely unstable and are frequently missed on initial presentation with catastrophic consequences.
A comprehensive narrative review of subaxial cervical spine injuries (C3–C7), covering epidemiology, anatomy, biomechanics, classification, and management. It addresses how to evaluate mechanical instability and neurologic status to guide surgical versus nonsurgical decisions, and examines ongoing controversies around closed reduction and methylprednisolone use.
When you see any subaxial cervical injury, structure your decision-making around three questions: Is it mechanically unstable? Is there neurologic compromise needing decompression? Are there patient factors (AS, DISH, obesity) that change the plan? When you see a patient with AS or DISH and even a low-energy fall, treat the cervical spine like a fractured long bone — these injuries are extremely unstable and are frequently missed on initial presentation with catastrophic consequences.