We reviewed 41 patients over the age of 65 years (mean 76.5) who had s
uffered cervical spine injuries, 12 of them with neurological deficit.
Eleven patients died during treatment, mostly from respiratory diseas
e. Seven patients were treated by surgical stabilisation, five by halo
traction, and the rest by rigid collars or halo-vests. The cervical i
njury was missed at the first examination in four patients. We conclud
e that most injuries can be treated by a rigid collar, and that the us
e of a halo-vest or surgical stabilisation are effective alternatives.
Bed rest and traction are poorly tolerated by old people. There shoul
d be a high index of suspicion that any elderly patient who presents w
ith a history of a fall or minor trauma may have a cervical spine inju
ry.