Treatment of Subaxial Cervical Spinal Injuries

Publication Date: March 1, 2013
Last Updated: March 14, 2022


Closed or open reduction of subaxial cervical fractures or dislocations is recommended. Decompression of the spinal cord/restoration of the spinal canal is the goal.

Stable immobilization by either internal fixation or external immobilization to allow for early patient mobilization and rehabilitation is recommended. If surgical treatment is considered, either anterior or posterior fixation and fusion is acceptable in patients not requiring a particular surgical approach for decompression of the spinal cord.

Treatment of subaxial cervical fractures and dislocations with prolonged bed rest in traction is recommended if more contemporary treatment options are not available.

The routine use of computed tomography and magnetic resonance imaging of trauma victims with ankylosing spondylitis is recommended, even after minor trauma.

For patients with ankylosing spondylitis who require surgical stabilization, posterior longsegment instrumentation and fusion or a combined dorsal and anterior procedure is recommended. Anterior standalone instrumentation and fusion procedures are associated with a failure rate of up to 50% in these patients.

Recommendation Grading



Treatment of Subaxial Cervical Spinal Injuries

Authoring Organization

Endorsing Organization

Publication Month/Year

March 1, 2013

Last Updated Month/Year

January 10, 2023

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Male, Adult

Health Care Settings

Ambulatory, Hospital

Intended Users

Physician, nurse, nurse practitioner, physician assistant


Management, Treatment

Diseases/Conditions (MeSH)

D013167 - Spondylitis, Ankylosing, D002574 - Cervical Vertebrae, D013124 - Spinal Injuries


ankylosing spondylitis, Anterior, Posterior stabilization, fusion procedures, subaxial cervical fracture, spinal injuries, cervical vertebrae