| Morbidity, Mortality and Treatment Outcome after Cervical Spine
Injuries In Elderly Patients |
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Morbidity , Mortality and Treatment Outcome after Cervical Spine Injuries In Elderly Patients |
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<p>Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea</p> |
| 경추손상 노인 환자에서의 이환율, 사망률 및 치료 결과 |
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| Abstract |
Object: Injuries of the cervical spine are not infrequent in the elderly and of ten occur with relatively minor trauma.
The prognosis, however, may vary with various factors involved. The aim of this study was to evaluate the mortality,
morbidity and treatment outcome in elderly patients with cervical spine injury.
Methods
We analyzed the morbidity, mortality and outcome of cervical spine injuries in patients over the age of
65 years. This study was a retrospective review of 54 elderly patients admitted to our tertiary referral spinal injury facility
with cervical spine injuries between 2005 and 2007. The male to female ratio was 2.1:1 (M=72, F=35).
Results
The mechanism of injury was a fall in 70% and road traffic accident in the remaining 23%. The level
involved was atlanto-axial in 22 cases, sub-axial in 26 cases and the remaining 6 had no bony injuries. Multilevel
involvement occurred in 24 patients. C2 dominated the single level injury and most of them were type II odontoid
fractures. Four patients had complete injuries, 14 incomplete injuries, and the remaining 38 had no neurological deficits.
Treatment included cervical orthosis in 34 cases, halo immobilization in 13, posterior stabilization in 6 patients and
anterior cervical fusion in three patients. The overall complication rate was 18.6% with an associated in-hospital
mortality of 11.2%. Among the 28.9% patients with neurological involvement, 37.7% had significant neurological
recovery. Sixty-seven patients (70%) completed the form, 20 patients (19%) were deceased at review and 8 patients
(7%) were lost from follow up evaluation.
Conclusion
Functional disability was more marked in the patients with neurologically deficit at the time of injury.
As in our series, neck pain in the elderly patients should be thoroughly evaluated to exclude C2 injuries. Most patients
can be managed with an orthosis but unstable injuries require rigid external immobilization or surgical stabilization. |
| Key Words:
ElderlyㆍCervical spine injuryㆍExternal immobilizationㆍOutcome |
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