Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature.
Of 300 patients who were hospitalized for acute cervical injuries, 216 lived, fifty-one died within four months of injury, and thirty-three were lost to follow-up. The important findings in a retrospective review were that laminectomy resulted in a high mortality rate and loss of motor function and that steroids did not improve neural recovery in quadriplegics and their use was associated with gastrointestinal hemorrhage. Closed or open reduction followed by posterior fusion for subluxations or dislocations, and anterior decompression and fusion for vertebral compression fractures, offered the best chance for recovery of neural function and restoration of stability. Massive epidural hemorrhage was found only in patients with ankylosing spondylitis.