Peck George Edward, Shipway David James Heming, Tsang Kevin, Fertleman Michael
a Division of Surgery , Imperial College Healthcare NHS Trust, St Mary's Hospital , London , UK.
b Division of Medicine , North Bristol NHS Trust, Southmead Hospital , Bristol , UK.
Br J Neurosurg. 2018 Jun;32(3):286-290. doi: 10.1080/02688697.2018.1445828. Epub 2018 Feb 28.
Developed populations are ageing rapidly and by 2040, approximately 1 in 4 adults will be over 65 years of age. This is resulting in higher incidence of traumatic injury in older patients. Cognitive and physical comorbidities in this group can pose significant challenges. Due to mechanisms of injury and pre-existing degenerative spinal disease, cervical spine fractures are particularly prevalent in elderly patients. These are associated with significant morbidity and mortality. In this literature review we examine current evidence surrounding the use of cervical spine immobilisation in elderly patients in the pre-hospital and emergency department setting and also as a treatment option for cervical spine fractures. We explore evidence surrounding the complications that can arise from cervical spine immobilisation, including the development of pressure sores, raised intracranial pressure, dysphagia, breathing difficulties, delirium, compliance issues, mobility and functional outcome.
发达人口正在迅速老龄化，到2040年，约四分之一的成年人将年满65岁。这导致老年患者创伤性损伤的发生率更高。该群体的认知和身体合并症可能带来重大挑战。由于损伤机制和已存在的退行性脊柱疾病，颈椎骨折在老年患者中尤为普遍。这些骨折与显著的发病率和死亡率相关。在这篇文献综述中，我们研究了有关在院前和急诊科环境中对老年患者使用颈椎固定以及作为颈椎骨折治疗选择的现有证据。我们探讨了围绕颈椎固定可能出现的并发症的证据，包括压疮的形成、颅内压升高、吞咽困难、呼吸困难、谵妄、依从性问题、活动能力和功能结局。
