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Cervical spine fractures in the elderly

S J Weller1, A M Malek, E Rossitch

  • 1Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Surgical Neurology
|March 1, 1997
PubMed
Summary

Elderly patients with cervical spine fractures often benefit from halo immobilization for C1-C2 fractures. Posterior cervical fusion is a safe option for elderly patients, especially for fractures unlikely to heal with external immobilization alone.

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Area of Science:

  • Orthopedics
  • Trauma Surgery
  • Geriatric Medicine

Background:

  • Cervical spine fractures are common in the elderly.
  • Management is challenging due to comorbidities and poor tolerance to immobilization.

Purpose of the Study:

  • To describe the clinical features, treatment, and outcomes of cervical spine fractures in elderly patients.
  • To evaluate the efficacy of different treatment modalities.

Main Methods:

  • Retrospective analysis of 10 elderly patients (≥70 years) with cervical spine fractures.
  • Treatments included halo immobilization, rigid cervical collar, and posterior cervical fusion.

Main Results:

  • Halo immobilization achieved osseous union in 5 of 6 patients.
  • Posterior cervical fusion resulted in osseous union in all 3 patients.
  • Philadelphia collar had mixed results with one union, one nonunion, and one death.

Conclusions:

  • Halo immobilization is preferred for most elderly C1-C2 fractures.
  • Philadelphia collar is useful when other treatments are contraindicated.
  • Posterior cervical fusion is safe and effective in the elderly and should be considered for specific fracture types.

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