CII arch fractures are divided into groups according not to anatomical localization, but to the instability degree resulted from the trauma. Effendi et al classification became greatly widespread. |t is based on the same stability criteria, but it is simpler, intelligible and gives the plan of treatment. All the fractures according to this classification are divided into three types: the first one consists in stable fractures in which even in functional images there is no any rough deformation at the level of CII segment; the second one consists in damages with significant angular (more than 11°) or shift (more than 3,5 mm) deformations, that indirectly indicates damage of soft tissue structures, and first of all diskoligamentous complex. The services of the authors of the present classification are also that they were the first who had defined fracture-dislocation of CII arch, attributed it to the third type. Choice of surgical procedure in unstable CII-III vertebral fractures is ventral spondylosyndesis of CII-III carried out by submaxillary approach after the preliminary closed elimination of deformation of upper cervical part of spine. The differentiated approach to the implant choice with an allowance for morphometric data allows to receive adequate decompression of nervous - vascular structures and reliable stabilization of the damaged segment
V.V. Ostrovskiy, V.G. Ninel, A.E. Shulga, A.A. Smoljkin, E.A. Anisimova Experience of surgical treatment of unstable СII vertebral fractures // Saratov Journal of Medical Scientific Research, Vol. 6, Issue 2, 2010, pp. 432-435

For the purpose of working out of the differentiated approaches to preoperative planning in each specific case on the basis of character estimation of spinal column and spinal cord damage 129 patients (112 men and 17 women) with subaxial damages in the cervical department of backbone have been examined. Morphological peculiarities of cervical vertebrae have been taken into account. The patients have been on treatment at Saratov Scientific Research Institute of Traumatology and Orthopedics from 2004 till 2007. Patients have been properly examined. Volume of surgical intervention from the frontal access and rational choice of implants have been carried out taking into account difficulty and extension of lesions of osseous structures, and morphometry data including in stabilization of vertebrae. The differentiated approach to the choice of implants has allowed in 85-90% cases to receive adequate decompression of neurovascular structures, reliable correction and stabilization of the damaged segment thus it has enabled possible early activization and social rehabilitation of patients of given category.
V.V. Ostrovsky, V.G. Ninnel, E.A. Anisimova MORPHOMETRICAL SUBSTANTIATION OF VENTRAL FIXATION USE IN SURGICAL REHABILITATION OF PATIENTS WITH SUBAXIAL DAMAGES OF CERVICAL DEPARTMENT OF SPINAL COLUMN // Saratov Journal of Medical Scientific Research, Vol. 5, Issue 1, 2009, pp. 100-103