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

Objectives: To compare the success rate and capacitiesof nonsurgical (halo cast) versus surgical management oflower cervical spine injury.Methods: Forty patients admitted to hospitals affiliatedwith Shiraz University of Medical Sciences in Shiraz, Iran,from August 2002 to August 2004 with unstable cervicalinjuries were divided into 2 equal groups (halo versussurgery), and in each group, patients were divided into 3categories based on the type of lesion. The percentage ofsagittal subluxation and degree of sagittal angulation werechosen as criteria for treatment outcome, and each wasmeasured on radiological images and recorded at the timeof admission and after 6 months.Results: Members of both groups showed significantimprovements in the criteria after treatment. The amountof correction in subluxation was not significantly differentbetween the 2 groups; however, the surgical approachresulted in a significantly better correction of angulation.Conclusion: The nonsurgical approach can be anacceptable alternative to surgical correction in selectedpatients with various lower cervical spine injuries andyielded comparable results; however, a larger sample sizeand longer follow-up may be necessary for verification.