The influence of the mechanism of cervical spine injury on the degree of the spinal cord lesion

Abstract

In the years 1965 to 1988, 1687 patients with cervical spine injury were treated in the acute post-traumatic period. In the analysed material commonest cause for the injury was by a flexion mechanism (48%), less frequently compressive (26%), and by a hyperextension mechanism (26%). Radiological changes were related, to some extent, with the patients age. Compression and flexion fractures occur most often in young people, dislocations in older ones, and injuries caused by hyperextension in, most often, elderly age (average age 53 years). The mechanism of the injury influences the degree of the nervous system injury. Serious consequences usually occur with crushing of a vertebral body. Serious neurological disturbance may occur with a flexion mechanism; and rarely such serious neurological disturbances accompany injuries caused by a compression mechanism. There was a complete lesion of the spinal cord in only 11% of patients. Neurological improvement was achieved in 51% of patients; 31% had no improvement, and 18% of patients died during treatment. The best results were observed in the group of typical compression fractures (neurological improvement--81%), whereas the poorest was found in patients with a crush type of fracture (improvement in 17%, mortality 18%), and in those with dislocation (improvement in 25%, mortality rate--23%).