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Cervical Spine Injuries in Patients 65 Years Old and Older

Epidemiologic Analysis Regarding the Effects of Age and Injury Mechanism on Distribution, Type, and Stability of Injuries

F. M. Lomoschitz1,2, C. C. Blackmore2, S. K. Mirza3 and F. A. Mann2

1 Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
2 Department of Radiology, Harborview Medical Center, 325 Ninth Ave., Box 359728, Seattle, WA 98104-2499.
3 Department of Orthopedic Surgery, Harborview Medical Center, Seattle, WA 98104-2499.



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  		Fig. 1. —Bar chart shows distribution and pattern of injuries in lower cervical spine. Note increased number of fractures in C5 and C6 levels, including both unstable hyperextension fracture and dislocations and minor stable fractures. Bilateral facet = fracture, dislocation, and fracture—dislocation; unilateral facet and minor = solitary transverse process fracture, solitary spinous process fracture, and solitary laminar fracture.

 


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  		Fig. 2. —Bar chart shows frequency of fracture level depending on age. Note increased frequency of fracture at C1 and C2 in patients older than 75 years (p = 0.003). White bar = patient age of 65-75 years (n = 96 injuries in 59 patients), black bar = patient age greater than 75 years (n = 129 injuries in 90 patients)

 


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  		Fig. 3. —Bar chart shows frequency of fracture level with regard to trauma mechanism. Patients with low-energy mechanism (fall from standing or seated height) were more likely to have sustained upper cervical spine fracture (p = 0.001). White bar = fall from standing or seated height (n = 67 injuries in 45 patients), black bar = high-energy injury (n = 158 injuries in 104 patients)

 

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