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Cervical spine injuries in the elderly

I H Lieberman¹, J K Webb

¹University Hospital, Queen's Medical Centre, Nottingham, England.

The Journal of Bone and Joint Surgery. British Volume

|November 1, 1994

Summary

Elderly patients with cervical spine injuries often present after falls. Most injuries are treatable with rigid collars, with halo-vests or surgery as alternatives.

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Area of Science:

Geriatric Medicine
Orthopedic Surgery
Trauma Care

Background:

Cervical spine injuries in elderly patients are challenging due to comorbidities and potential for missed diagnosis.
Falls are a common mechanism of injury in this demographic.

Purpose of the Study:

To analyze the outcomes of cervical spine injuries in patients over 65 years old.
To evaluate different treatment modalities for geriatric cervical spine trauma.

Main Methods:

Retrospective review of 41 patients aged 65+ with cervical spine injuries.
Analysis of injury patterns, neurological deficits, treatment methods, and outcomes.
Categorization of treatments including rigid collars, halo-vests, halo traction, and surgical stabilization.

Main Results:

12 out of 41 patients had neurological deficits.
Mortality rate was significant (11 patients), primarily due to respiratory complications.
Rigid collars were used for the majority of patients, with halo-vests and surgical stabilization also employed.
Four cases involved missed cervical spine injuries on initial examination.

Conclusions:

A high index of suspicion is crucial for diagnosing cervical spine injuries in elderly patients presenting after falls or minor trauma.
Rigid collars are effective for most injuries, while halo-vests and surgical stabilization offer viable alternatives.
Conservative measures like bed rest and traction are poorly tolerated in the elderly population.

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