Indication, surgical technique, and results of 100 surgically-treated fractures and fracture-dislocations of the cervical spine

Abstract

The results of 100 cervical spinal injuries in 67 men and 33 women (20 upper and 80 lower cervical spinal injuries), which were treated operatively, were analyzed. Fifty-three of the patients were less than 30 years old. The period of observation was a minimum of one year. Ninety-three percent of patients were transported to a hospital where first treatment was given within six hours after the accident. Only 25% of these patients had a closed manual or open reduction within these first six hours. One third of all patients improved neurologically. The majority (75%) of the patients with neurologic improvement were reduced within six hours after the accident. Fifty patients were treated by an anterolateral, 40 by a posterior, and ten by a combined anterior/posterior surgical exposure. Complications attributable to technical difficulties were only occasional and were never of significance for the further outcome. The duration of immobilization was a maximum of six weeks or less in more than 85% of all cases. The duration of hospitalization could not be reduced in the group of tetraplegic patients. Immediate reduction of the injury is more important for the further neurologic outcome than improved surgical techniques.