Injuries of the cervical spine

Abstract

Seventy-one patients of 119 with injury of the cervical spine were re-examined an average of 5 years and 5 months after the accident. The mean age of the patients was 39 years. There were 91 male and 28 female patients. The majority of injuries (51) were sustained by car drivers and passengers involved in traffic accidents. More than one cervical vertebra was damaged in 36 patients. Neurological lesions were observed in 59 patients; tetraplegia was present in 19 of these. The average duration of hospital treatment was 37 days. Twenty-four patients were treated at the intensive care unit. Skull traction was used in 69 cases for an average of 38 days to bring about reduction and immobilization. Reduction and anterior spondylodesis by Cloward's technique was performed on 13 patients. Of the operated patients, 11 showed root symptoms or incomplete cord lesions. The 19 tetraplegics were all conservatively treated. Fourteen patients died of their cervical spine injuries and 7 remained permanently disabled. Half the patients recovered to a pain-free state and one third became asymptomatic. Of the radiological deformities observed on admission, lowering of the disc space increased during follow-up, and forward sliding, increase in interspinous distance and narrowing of the vertebral canal decreased. The clinical result was poorer if flexion deformity, compression, forward sliding, narrowing of the vertebral canal or lowering of the disc space were observed at the last radiological examination.