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Management of Type II Odontoid Fractures: Experience from Latin American Spine Centers.
- Source :
-
World neurosurgery [World Neurosurg] 2017 Feb; Vol. 98, pp. 673-681. Date of Electronic Publication: 2016 Oct 31. - Publication Year :
- 2017
-
Abstract
- Objective: To analyze characteristics of type II odontoid fracture (TII-OF), including clinical and radiographic factors, that influence surgical planning in 8 Latin American centers.<br />Methods: Retrospective chart review was performed of 88 patients with TII-OF between 2004 and 2015 from 8 Latin American centers. Parameters studied included 1) demographic data and causes of TII-OF, 2) clinical and neurologic presentation, 3) characteristics of fracture (degree of odontoid displacement, displacement of odontoid relative to C2 body, anatomy of fracture line, distance between fragments, presence of comminution, contact area between odontoid and C2 body), 4) type of treatment, and 5) clinical and radiographic outcome. Bone fusion was assessed using computed tomography.<br />Results: Mean patient age was 45.33 years ± 23.54; 78.4% of patients were male. Surgery was the primary treatment in 65 patients (73.8%), with an anterior approach in 64.6%. Surgery was usually preferred in patients with posterior or horizontal oblique fracture lines, local pain, and a smaller bone contact surface between the odontoid and the body of C2. A posterior approach was chosen when distance between the fractured bone fragments was >2 mm or after failed conservative or anterior odontoid screw treatment in a symptomatic patient.<br />Conclusion: The treatment of choice for TII-OF in 8 Latin American trauma centers was surgery through an anterior approach using screw fixation. Posterior segmental C1-C2 fixation was indicated when distance between bone fragments was >2 mm and in symptomatic patients with nonunion.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Accidental Falls statistics & numerical data
Accidents, Traffic statistics & numerical data
Athletic Injuries diagnostic imaging
Athletic Injuries epidemiology
Athletic Injuries surgery
Bone Screws
Braces statistics & numerical data
Female
Fracture Fixation instrumentation
Fracture Fixation methods
Fracture Fixation statistics & numerical data
Humans
Latin America epidemiology
Male
Middle Aged
Odontoid Process diagnostic imaging
Postoperative Complications epidemiology
Postoperative Complications etiology
Radiography
Retrospective Studies
Spinal Fractures diagnostic imaging
Spinal Fractures epidemiology
Surgicenters statistics & numerical data
Treatment Outcome
Odontoid Process injuries
Spinal Fractures surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 98
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 27810454
- Full Text :
- https://doi.org/10.1016/j.wneu.2016.10.120