Tear-drop fractures of the lower cervical spine: classification and analysis of 54 cases

Tear-drop fractures, as described by Schneider and Kahn, are by definition unstable injuries, since both bony and ligamentous elements are involved in such lesions. Fifty-four patients having sustained the above-mentioned injury were treated in our Orthopaedic Department during the last 36 years, representing the 8.1% of all cervical spine injuries. Those patients, 45 men and 9 women, of a mean age of 34.3 years, were injured following a RTA (63%), or a fall from the height (22.2%). Fifty-five percent of those patients suffered spinal cord injury. These injuries were classified in four types (I, II, III, IV) according to the severity of the lesions and were treated accordingly. The whole spectrum of the medical records were analysed and discussed in relation to the available bibliography. Attention was paid to the presence of neurological lesions and the severity of the injury. It was shown that Type I lesions respond satisfactory to conservative treatment, while Types III and IV have an absolute indication for surgical treatment.