Cervical C4 and C5 vertebra fractures can be managed in lot of ways depending upon nerve compression and the presence of instability. Stability or instability is assessed based on the X-ray, CT and MRI findings. If there is nerve compression, it needs to be decompressed surgically. Then the instability needs to be stabilized. Stabilization can be done from front or back or both sides using plates, screws and rods. Bone graft may be required in some cases to fill gaps.