Neurospine.  2020 Dec;17(4):710-722. 10.14245/ns.2040282.141.

Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

  • 1Department of Neurosurgery, Ege University, Izmir, Turkey
  • 2LosCobos Medical Center, Bogotá, Colombia
  • 3N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
  • 4El Bosque University, Bogotá, Colombia
  • 5Trauma and Orthopedics Institute, Privolzhsky Research Medical University, Nizhniy Novgorod, Russian Federation


Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.


Spine trauma; Cervical spine injury; Spinal immobilization; Patient transportation; Closed reduction; Cervical facet dislocation
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