A Clinical Analysis and Treatment of Traumatic Cervical Spine Patients

Kim, Gyoung Beom; Choi, Hyu Jin; Shin, Hyun Chul; Kim, Ik Su; Kim, Ki Uk; Huh, Jae Taec; Kim, Hyoung Dong

Abstract

The authors reviewed 90 patients with traumatic cervical spine injury admitted to our department between January, 1993 and December, 1997. The most common age group was 21-30 years old. The male to female ratio was 7.2 : 1. Motor vehicle accident was the most frequent cause of traumatic cervical spine injury. The most common mechanism of injury was compressive and then distractive flexion. The C2 body fracture was the commonest of the vertebral body fractures and C5/6 dislocation was the most common involved level of injured vertebrae. Forty-seven of these patients were managed with conservative treatment and the remaining 43 patients underwent surgery. The conservative treatment was consisted of skeletal traction, neck collar and Halo-vest application. Of 43 patients operated, 24 patients were performed by anterior approach and 10 by posterior approach and remaining 9 patients were treated by anterior approach after posterior approach. According to Modified Frankel's grading system, the rates of neurological impr-ovement at anterior approach, posterior approach and combined approach were 79.2%, 60.0% and 66.0%, respec-tively. Difference of improvement rates did not have clinical significance. There were 76 types of associated injuries were observed in 51 patients. The most common associated injury was head trauma and surgical intervention was required in 5 patients among them. The common complications were respiratory disorder, bed sore, urinary tract infection, gastrointestinal bleeding, pin site infection in decreasing order of frequency. The most common cause of death was respiratory disorder including pneumonia, atelectasis, acute respiratory distress syndrome and pulmonary edema.