[Treatment of fractures of the upper cervical spine (C1 and C2)].

The authors provide a review of current opinions on the treatment of fractures in the region of C1 and C2. It is necessary to take the possibility of this localization of fractures into consideration in polytraumatized patients, in those unconscious, and in cases of algesia in the cervical region. A significant post in diagnostics belongs to CT examination which reveals the extent and type of fracture and the degree of dislocation. The authors refer to the classification of Aebi and Nazarian which should be accepted in spondylo-surgical practice. The authors recommend conservative therapy of atlas fractures, preferably by the use of Halo-apparatuses. The direct osteosynthesis by means of two compressible screws according to Böhler/Magerl represents the method of choice in treating dens fractures. The surgical modification utilizing a small T splint was proved competent in fractures interfering the vertebral corpus (type III). Fractures of isthmus with no dislocation are recommended to be treated conservatively by the use of Halo-fixation, in cases with dislocation (types E II, E III) they consider the method of intercorporal desis C 2/3 according to Decaulx and modified by Caspar, to be optimal. (Fig. 8, Ref. 20.).