Analysis of Upper Cervical Injuries

ABSTRACT

During the past five years we have treated twenty-seven cases of upper cervical injury among total three hundred and seventeen spine injuries. A follow-up study has done on twenty-one upper cervical injuries and the result is reported. The incidence of upper cervical injury was 8.5% of the total spine injury and 17.5% of the cervical injury. Almost all of the injuries(95.2%) were caused by traffic accidents and falls. The types of injury were odontoid fracture(38.1%), hangman's fracture(28.6%), atlanto-axial instability(19.1%), tear drop fracture of the axis(9.5%), and Jefferson's fracture(4.8%). Chief complaints on admission were motor weakness(57.1%), neck pain with limitted range of motion(42.9%), and sensory disturbance was noted in six cases of the motor weakness group(28.6%). Out of twenty-one cases, operative fixation was performed in eight cases with good result in five(62.5%) and thirteen patients were treated conservatively with eleven cases(84.6%) of good result. In chronic nonunited or malnunited cases, it seems to be safer to fuse the level both by anterior and posterior routes than by either route alone because it is not always stable and needs long period of immobilization.