Comparison of outcome of surgical and nonsurgical methods in the treatment of unstable traumatic lesions of the lower cervical spine

OBJECTIVE: To compare the success rate and capacities of nonsurgical (halo cast) versus surgical management of lower cervical spine injury.

METHODS: Forty patients admitted to hospitals affiliated with Shiraz University of Medical Sciences in Shiraz, Iran, from August 2002 to August 2004 with unstable cervical injuries were divided into 2 equal groups (halo versus surgery), and in each group, patients were divided into 3 categories based on the type of lesion. The percentage of sagittal subluxation and degree of sagittal angulation were chosen as criteria for treatment outcome, and each was measured on radiological images and recorded at the time of admission and after 6 months.

RESULTS: Members of both groups showed significant improvements in the criteria after treatment. The amount of correction in subluxation was not significantly different between the 2 groups; however, the surgical approach resulted in a significantly better correction of angulation.

CONCLUSION: The nonsurgical approach can be an acceptable alternative to surgical correction in selected patients with various lower cervical spine injuries and yielded comparable results; however, a larger sample size and longer follow-up may be necessary for verification.