Learning objectives
Mechanism and clinical features of underlying spinal injuries in the elderly.
Imaging techniques.
Pictorial review of common patterns of injury.
Background
The number of fall-induced injuries has increased as the general population has aged over the last decade.
Traumatic injuries to the spinal cord/column can result in significant morbidity,
disability ,and even,
death.The ideathat these injuries occurs in isolation and only to adolescents and young adults is a misconception and recentepidemiological studies (1) suggests the first peak occurs as expected in young adults,
however,
the second peak occurs to the elderly population.
Clinical diagnosis of cspine injuries in the elderly is difficult and complex due to...
Imaging findings OR Procedure details
Events leading to cervical spine injuries in the elderly are commonly considered as trial mechanism in younger adults.
Fall from standing from or seating heights are the most common causative mechanism for cervical spine injuries (2).
Majority of cervical spine injuries involves one or more levels of the cervicocranium with C2 injuries being the most common and injuries frequently asssociated with fractures of C1.
In the healthy young individual the most mobile segments are C4-C7 and not surprisingly the most common injuries in the age...
Conclusion
As the elderly population increases and becomes more active,
the prevalence of such age group presenting with cervical spine injuries also increases.
Unlike the younger age group,
significant injury to the cervical spine may result from minor blunt trauma such fall from seated or standing height.
Cervical spine trauma are most common in the C1/2 and C4/5 (hyperextension injuries) regions and are often more than one level.
Ina large proportion of patientsthese injuriesare highly unstable resulting in high morbidity and mortality.
Clinical evaluation and imaging...
References
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Fehlings MG: Medical co-morbidities,
secondary complications,
and mortality in elderly with acute spinal cord injury.
J Neurotrauma.
2003 Apr;20(4):391-9.
Weller SJ,
Malek AM,
Rossitch E.
Cervical spine fractures in the elderly.
Surg Neurol 1997;47:274 -281
White AA,
Panjabi MM.
Clinical biomechanics of the spine,
2nd ed.
Philadelphia: Lippincott,
1990; 97-119
Blackmore CC,
Ramsey SD,
Mann FA,
Deyo RA.
Cervical spine screening with CT in trauma patients: a cost-effectiveness analysis.
Radiology 1999;212:117 -125
Fehlings MG,
Rao SC,
Tator CH,
Skaf G,
et...