Skip to main content
  • Complications and Long-term Outcomes After Open Surgery for Traumatic Subaxial Cervical Spine Fractures: A Consecutive Series of 303 Patients

    Final Number:

    Hege Linnerud Fredoe MD; Syed Rizvi; Marianne Harr; mehran rezai MD; pål rønning MD; Bjarne Lied MD; Eirik Helseth MD, PhD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Knowledge of surgical complications, and expected long-term outcomes after surgery, are important in the decision process for surgical treatment of subaxial cervical spine fractures (S-CS-fx).

    Methods: Medical charts for 303 patients surgically treated for S-CS-fx in the years 2002- 2010 were retrospectively reviewed. The surviving patients participated in a prospective long-term follow-up, including clinical history, physical examination and updated cervical CT.

    Results: The median patient age was 49 years (range 14.7–93.9), and 74% were males. Preoperatively, 43% had spinal cord injury (SCI), and 27% exhibited isolated radiculopathy. The risks of SCI deterioration and new-onset radiculopathy after surgery were 2.0% and 1.3%, respectively. Surgical mortality (death within 30 days)was 2.3%. These patients were all =80 years of age or had a severe head injury. The reoperation rate was 7.3%. At the long-term follow-up conducted a median of 2.6 years after trauma (range 0.5–9.1), 256 (99.2%) of the patients who had survived and were living in Norway participated. Of the patients with American Injury Severity Scale (AIS) A–D at presentation, 51% had improved one or more AIS grades. Of the patients with preoperative radiculopathy, 89% were without symptoms. The bony fusion rate was 98%.

    Conclusions: In this large consecutive series of patients with S-CS-fx treated with open surgical fixation, the surgical mortality was 2.3%, the risk of neurological deterioration was 3.3% and the reoperation rate (any cause) was 7.3%. The neurological long-term results were good, with 51% improvement in AIS grade and resolution of radiculopathy in 89% of the patients. Bony fusion was 98%. Considering the high risk of morbidity that subaxial cervical spine fractures may entail, the surgical risk in this series was considered acceptable.

    Patient Care: Knowledge of complications and the expected long-term outcome after surgery for cervical fractures are of major importance for patient information and treatment planning.

    Learning Objectives: To describe complications and outcome in surgically treated subaxial cervical spine fractures.


We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy