Management of nonoperative cervical spine fractures: An institutional analysis of follow-up duration and image acquisition

Alison M Westrup; Landon S Hendrickson; Kendall L Hughes; Jaylun I Smith; Christen M O'Neal; Sixia Chen; Andrew K Conner

doi:10.25259/SNI_107_2022

Management of nonoperative cervical spine fractures: An institutional analysis of follow-up duration and image acquisition

Surg Neurol Int. 2022 Jun 23:13:260. doi: 10.25259/SNI_107_2022. eCollection 2022.

Authors

Alison M Westrup¹, Landon S Hendrickson¹, Kendall L Hughes¹, Jaylun I Smith¹, Christen M O'Neal¹, Sixia Chen², Andrew K Conner¹

Affiliations

¹ Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, United States.
² Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, United States.

Abstract

Background: How long do nonoperative cervical fractures have to be followed and with how many imaging studies?

Methods: We reviewed 69 adult patients with 122 (31 occiptocervical and 91 sub-axial) cervical fractures; at least one of the cervical fractures was managed nonoperatively. Outcomes were assessed along with the optimal follow-up duration and frequency of various diagnostic studies.

Results: An average of four follow-up visits occurred on average 28-, 66-, 94-, and 158-day post hospital discharge. The average time between discharge and orthotic clearance was 70 days (±32.4 days). Radiographic studies were obtained at follow-up visits, respectively, in, 82.6%, 83.6%, 94.7%, and 100% of patients.

Conclusion: The trend for managing nonoperative cervical fractures was an unduly prolonged follow-up duration that included obtaining too many imaging studies.

Keywords: Cervical fracture; Cervical spine; Conservative management; Non-operative; Orthotic.

Grants and funding

U54 GM104938/GM/NIGMS NIH HHS/United States