Sub-axial cervical spine fractures can have devastating sequalae. A third of all spine injuries occur in the cervical region. 70% of cervical trauma occurs in sub axial region. Failure of proper management to sub-axial cervical spine trauma can lead to permanent disability lack of consensus in the management of sub-axial fracture questions the efficiency of different surgical approaches. Aim of Study: Evaluation of different anterior surgical methods in treatment of sub-axial cervical spine

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... ma and fracture. Patients and Methods: 42 patients with sub-axial cervical spine fractures who all were treated surgically with anterior approach were recruited. Of 42, 21 (50%) had corpectomy and Pyramesh placement with plate and 21(50%) had ACDF with single/multiple cages with or without plating. We collected operative data and performed follow-up for 12 months postoperatively. The collected data were analyzed using the SPSS to detected significant differences between both groups. Study Design: Case series. Results: Age of patients in the Study groups ranged from 15 years to 70 years, (average 39.1 ± 13.8 years). The injury levels in the majority of the 42 cases were at C4-5 (47.6%), C5-6 in (33.3%), C3-4 in (9.5%), C6-7 in (9.5%). Corpectomy group had significantly more blood loss and longer operative time than ACDF group. Both groups had similar rate of postoperative complications. Conclusion: Anterior approaches for sub-axial fractures are efficient in preserving neurological function and stabilizing the fractures. Moreover, anterior procedure takes short time and could be of significant value in patients with medical comorbidities or when a short operative time is required.