The stability of the cervical spine following the conservative treatment of fractures and fracture-dislocations

Abstract

There are many classifications of injuries of the cervical spine. This is not the place to debate their merits and demerits. Suffice it to say that in this paper the classification used is broadly based on that proposed by Holdsworth (1963), and also relates to the work of Roaf (1960) and Beatson (1963), whose important experimental work increased the general understanding of the mechanisms involved. However, and this point must remain to be argued later, it is felt that these authors oversimplify flexion-rotation injuries and Stringa's (1963) subgroup of 'anterior subluxations' is included. Classification and Incidence I. Atlanto-axial injuries. 8 2. Flexion-rotation injuries 95 (a) Anterior subluxations 19 (b) Flexion-rotation dislocations and fracture-dislocations with unilateral posterior intervertebral joint dislocation 41 (c) Flexion-rotation dislocations and fracture-dislocations with bilateral posterior intervertebral joint dislocations

Cervical ankylosis with acute spinal cord injury

“…Of the six cases with congenital fusion, three injuries were caused by Many authors have reported the phenomenon of rapid bony consolidation of injuries to the ankylosed cervical spine. They include Ackerman (1972), Bergmann (1949), Cheshire (1969), Good (1967), Grisolia et al (1967) and Rand and Stern (1961). Our experience (Table IV) substantiates their observations.…”

“…Our experience is consistent with the observation of authors who have previously stressed this important clinical point. They include Guttmann (1966), Burke (1971), Cheshire (1969), Taylor (1953), Brain andWilkinson (1967), Symonds (1953), Osgood et al (1973, 1975, Rand andStern (1961), Schneider et al (1954), and Woodruff and Dewing (1963). All eight of our cases of ankylosing spondylitis had historical or radiographic evidence of an extension mechanism.…”

“…Stiasny (1933) reported the first case of cervical spinal cord injury associated with ankylosing spondylitis and made three important observations: delayed onset and diagnosis, the absence of major neuro logical change and a rapid bony consolidation. Subsequently, a number of cases have been reported by authors such as Bergmann (1949), Cheshire (1969), Hollin et al (1965), Guttmann (1966), Symonds (1953), Hughes and Brownell (1963), Woodruff and Dewing (1963), Osgood et al (1973Osgood et al ( , 1975, Rand and Stern (1961).…”

Cervical spine injuries: a follow-up of 332 patients

“…They are characterised by descriptions based on X-rays or classifications according to the assumed genesis (Cheshire, 1969;Holdsworth, 1970) and do not have as bad a reputation as injuries in the upper cervical region, but they may be as sociated with tetra-or paraparesis. In the present study injuries to the C5 level showed the most frequent association with tetraparesis.…”

Anterior plating of unstable cervical spine fractures

“…However, studies comparing this technique with posterior procedures show that anterior decompression and fusion has a higher incidence of complications (Bedbrook, 1966;Cheshire, 1969;Meyers, 1967;Stauffer, 1977;Van Peteghem 1979). Two prior studies have documented a low incidence of graft displacement or late kyphosis, but they included only a limited number of patients with unstable injuries (Cloward, 1969;Meyers, 1967).…”