[Cervical spine injuries in the elderly patient]

Area of Science:

• Orthopedics
• Geriatric Medicine
• Radiology

Background:

• Cervical spine injuries are increasingly prevalent in the elderly population.
• Prompt clinical evaluation and diagnostic imaging are essential for timely and effective treatment.
• Age-related changes in spinal flexibility can increase fracture instability.

Purpose of the Study:

• To review diagnostic modalities for cervical spine injuries in elderly patients.
• To outline current treatment strategies for cervical spine fractures in this demographic.
• To discuss factors influencing treatment selection and clinical outcomes.

Main Methods:

• Review of current literature on cervical spine injuries in elderly patients.
• Discussion of diagnostic imaging techniques including computed tomography (CT) and magnetic resonance imaging (MRI).
• Analysis of conservative and surgical treatment options, including orthoses and spinal fixation.

Main Results:

• CT scans are recommended for excluding cervical spine injuries.
• Dynamic fluoroscopy and MRI aid in detecting instabilities.
• Treatment selection must balance fracture severity with potential impact on quality of life, especially with rigid immobilization or halo fixators.

Conclusions:

• Operative treatment for upper cervical spine fractures is reserved for unstable atlas and axis fractures.
• Subaxial cervical spine fractures in the elderly are often unstable (AO Spine types B and C), frequently requiring surgical intervention.
• Pre-existing spinal stenosis can exacerbate neurological symptoms and negatively affect outcomes.