Innovative internal fixation for cervical spine fractures.

The increase in the number of available internal fixation devices for the cervical spine has promoted innovative stabilization of traumatic instability of the craniocervical junction. Traumatic injuries involving the craniocervical junction vary widely because of the complex osseous and ligamentous anatomy. These injuries can be purely ligamentous, such as occipitocervical dislocation, or can include single or multiple bony levels. Rare, however, are occasions of isolated osseous fractures without ligamentous damage. The extent of ligamentous damage usually dictates the presence of instability and the need for surgical fixation.