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The Journal of Bone and Joint Surgery, Vol 61, Issue 8 1119-1142, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc
Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature
HH Bohlman
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.
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