Background: Cervical 2 (C2) fractures in the elderly are common, and the incidence of these fractures has been increasing. Furthermore, the current treatment strategy for C2 fractures has been documented. Il peut y avoir des petites séquelles telles que des douleurs chroniques ou des troubles fonctionnels. Aydinli U, Kara GK, Ozturk C, Serifoglu R. Surgical treatment of odontoid fractures with C1 hook and C2 pedicle screw construct. Cervical vertebrae support your head and allow your neck to bend and twist. C1 fractures should be promptly identified and treated in all patients although they rarely require surgery. In 1998, hospital costs were $24,423 with 4,991 discharged. Beyond that, the regions of Uppsala and Malmö are highly urbanized. he incidence of VAI (as defined by magnetic resonance imaging/angiography [MRI/A]) in subtypes of C2 fractures. C2 Fracture Recovery Time Elderly . Effects of age group and gender on treatment allocation and C2 fracture distribution were tested with Chi-square test. [18]  In this study, operative treatment had a significant advantage in 30-day survival advantage, and a trend toward improved longer-term survival was noted. Neurosurgery. However, in the age group ≥ 70, the annual incidences of O2 and O3 fractures together almost tripled from 7.4 per 100,000 person-years in 2002 to 22.1 per 100,000 person-years in 2014 (Figure 3). Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J. Society The same trend has been shown in some earlier studies [12, 27, 28]. If reduction is unacceptable, weighted extension traction resumes for up to 6 weeks, followed by halo treatment for 6 weeks. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Patients that did not fulfil the criteria of any of these classification systems were classified as atypical C2 fractures—referred to as A. [10, 16, 20–22]. Level of Fracture C1 59 (36.6) C2 116 (72.0) C3 18 (11.2) C4 20 (12.4) C5 29 (18.0) C6 43 (26.7) C7 46 (28.6) Mechanism of Injury Fall 131 (81.4) Motor vehicle collision 24 (14.9) Other 6 (3.73) Dysphagia Y/N 42 (26.1) OD was present in 42 patients (26.1%) versus 119 (73.9%) patients without OD. This study was designed to identify the proportions of the second cervical vertebra (C2) fracture subtypes and to present age and gender specific incidences of subgroups. Single institute experience on 108 consecutive cases of type II odontoid fractures: surgery versus conservative treatment. Cuando se rompe, no se puede girar y torcer el cuello libremente. Parker SL, McGirt MJ, Garcés-Ambrossi GL, Mehta VA, Sciubba DM, Witham TF, et al. J Trauma. In the age group ≥ 70 years, O2 and O3 fractures dominated, whereas there was a more even distribution among the various fracture types in the younger age group. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI2NzE1MC10cmVhdG1lbnQ=, Internal fixation (odontoid screw fixation), Atlantooccipital and atlantoaxial dissociation. Previous publications find among odontoid fractures a distribution of 0–4% of type 1, 60–80% type 2, and 20–39% type 3 according to Anderson and D’Alonzo [10, 14, 17–19]. C2.2: Wedge fracture of the vertebra with rupture of the posterior ligament complex (1) Osteoligamentous (2) Solely ligamentous C2.3: Vertebral body fracture (fissure in anterior superior portion + posterior fragment with dislocation greater than 3 mm in the spinal canal) (tear drop fracture) (1) Osteoligamentous (2) Solely ligamentous. Chapman J, Smith JS, Kopjar B, Vaccaro AR, Arnold P, Shaffrey CI, et al. [Medline]. Subgroup proportions of Hangman’s fractures are in 29–72% type 1, 28–69% type 2, and 0–10% type 3 classified according to Effendi et al. The halo vest is in place for 12-16 weeks and the fusion rate is over 90%. Surgical treatment options for these fractures include C2 transpedicular screw fixation along with odontoid screw fixation. Stulík J, Nesnídal P, Kryl J, Vyskočil T, Barna M. [Unstable injuries to the upper cervical spine in children and adolescents]. WHILE YOU ARE HERE: Informed consent. Jeffrey A Goldstein, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, AOSpine, Cervical Spine Research Society, International Society for the Advancement of Spine Surgery, International Society for the Study of the Lumbar Spine, Lumbar Spine Research Society, North American Spine Society, Scoliosis Research Society, Society of Lateral Access SurgeryDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Medtronic, Nuvasive, NLT Spine, RTI, Magellan Health
Received consulting fee from Medtronic for consulting; Received consulting fee from NuVasive for consulting; Received royalty from Nuvasive for consulting; Received consulting fee from K2M for consulting; Received ownership interest from NuVasive for none. 2009 Jul. [Medline]. Regarding the treatment of odontoid fracture type 1 most authors recommend nonsurgical treatment [9, 10]. The currently available data on the distribution of C2 fracture subtypes is sparse. 37 (1):30-4. Society. [Medline]. A more specific age distribution of C2 fractures is shown in Figure 2. Two-hundred and thirty-three patients (118 women) with a mean age of years (range 17–97) were treated for a C2 fracture. Patients with odon-toid fracture, hangman’s fracture, pars interarticularis or facet fractures were excluded, as were C2 body fractures associated with fractures elsewhere in the cervical spine (e.g., C1). Copyright © 2017 Anna-Lena Robinson et al. 64 (5 Suppl 2):343-8; discussion 348-9. Eur Spine J. Bilateral C2 pars interarticularis fractures are seen. Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients. C2 Fracture Symptoms . Since C2 fracture types are associated with different fracture mechanisms, the distribution of various fracture types differ between younger and older patients [10]. Methods. Abnormal movement of neck bones or pieces of bone can cause a spinal cord injury resulting in loss of sensation, paralysis, or usually instant death. Objective: To estimate the incidence and to describe the clinical results of the nonoperative management of vertical C2 body fractures. Please login or register, to gain full access to this case and participate in the discussion. a)Lésions nerveuses. After placement of bilateral C1and C2 screws and rods, one can place a cross link and compress the rods together, thereby reducing the fracture. 1, 2 The growing elderly population in the United States has seen the incidence of odontoid fractures more than double over the past decade. Unless there is retropulsed fragment of bone, patients usually do not have a spinal cord injury or neurologic deficits because the fracture spread outward or radially. [15]. The authors declare that they have no competing interests. 1264627-overview Furthermore, rates of malunion, nonunion, and pseudarthrosis formation are very low. Symptoms of a minor C2 fracture can include problems moving the neck, pain, swelling, tenderness, trouble swallowing, loss of feeling or a tingling sensation in the arms and legs,numbness or pain at the base of the head, double vision, or loss of consciousness. A propósito de un caso Chronic neck pain in a patient with a C2 fracture. 2008 Apr. 70 (5):1055-9; discussion 1059. . About 5% of patients with cervical spine injuries primarily do not seek any medical assistance for their neck injury [41]. Koller H, Acosta F, Tauber M, Komarek E, Fox M, Moursy M, et al. The risks of nonunion, malunion, and pseudoarthrosis formation are lessened with surgical treatment. Cervical spine trauma: unstable fractures, C2-C7 injuries, and imaging guidelines. 2017, Article ID 8321680, 7 pages, 2017. https://doi.org/10.1155/2017/8321680, 1Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden, 2Stockholm Spine Center, Stockholm, Sweden, 3Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden. Fractura del proceso odontoideo: este proceso es una parte de la vértebra C2 o eje. Odontoid fractures are the most common fracture of the axis and are the most common type of cervical spine fracture in patients over 65. The details in various age and gender groups are presented in Table 1. A dataset of all patients treated between 2002 and 2014 for C2 fractures was extracted from the regional hospital information system. J Spinal Disord Tech. The higher rate of the odontoid fracture type 2 proportion in elderly can be explained by the typically osteoporotic nature of this fracture type [23]. Se trata de una lesión estable, por lo que su tratamiento es la inmovilización con collarín rígido. Follow-up is critical for any patient sustaining a C2 fracture. Complications. C2 fractures can be subdivided into odontoid fractures, Hangman’s fractures, and atypical fractures [9]. Treatment for type I C2 (axis) fractures is hard-collar immobilization for 6-8 weeks, which usually is quite successful. Eur Spine J. Curr Probl Diagn Radiol. Introduction. Methods: An 8-year retrospective review of upper cervical spine injuries from the registry of a level I trauma center identified 21 patients with a vertical C2 body fracture. In Sweden all patient contacts within the public healthcare system are registered prospectively in a national patient registry with unique personal identification number and diagnosis codes using the 10th version of the International Classification of Diagnosis (ICD-10) [13]. Within C2 fractures, the hangman's fracture accounts for 23% of occurrences while the odontoid or dens fracture accounts for 55% of them. 2007 Jul. Selecciona Tus Preferencias de Cookies. Over the investigated years there was change in odontoid fracture subgroup distribution. One-hundred and forty-five of the fractures were odontoid, 9 were Hangman’s, and 9 were atypical. [12, 13, 3, 14], Management with the halo vest usually is considered if the initial dens displacement is less than 5 mm, the reduction is performed within 1 week of the injury and is able to be maintained, and the patient is younger than 60 years. [Medline]. Aydinli U, Kara GK, Ozturk C, Serifoglu R. Surgical treatment of odontoid fractures with C1 hook and C2 pedicle screw construct. The 7 cervical vertebrae are called C1 through C7. 2007 Nov. 61 (5 Suppl 2):311-5; discussion 315-6. To define the association between the incidence, morphology, and severity of C2 fractures, based on fracture angulation and comminution, and the occurrence of VAI.