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Odontoid Fractures
- Source :
- Clinical Spine Surgery: A Spine Publication. 32:313-323
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Odontoid fractures represent one of the most common and controversial injury types affecting the cervical spine, being associated with a high incidence of nonunion, morbidity, and mortality. These complications are especially common and important in elderly patients, for which ideal treatment options are still under debate. Stable fractures in young patients maybe treated conservatively, with immobilization. Although halo-vest has been widely used for their conservative management, studies have shown high rates of complications in the elderly, and therefore current evidence suggests that the conservative management of these fractures should be carried out with a hard cervical collar or cervicothoracic orthosis. Elderly patients with stable fractures have been reported to have better clinical results with surgical treatment. For these and for all patients with unstable fractures, several surgical techniques have been proposed. Anterior odontoid fixation can be used in reducible fractures with ideal fracture patterns, with older patients requiring fixation with 2 screws. In other cases, C1-C2 posterior fixation maybe needed with the best surgical option depending on the reducibility of the fracture and vertebral artery anatomy. In this paper, current evidence on the management of odontoid fractures is discussed, and an algorithm for treatment is proposed.
- Subjects :
- medicine.medical_specialty
Vertebral artery
Bone Screws
Nonunion
03 medical and health sciences
Fixation (surgical)
0302 clinical medicine
Posterior fixation
Older patients
medicine.artery
Odontoid Process
Humans
Medicine
Orthopedics and Sports Medicine
030222 orthopedics
business.industry
medicine.disease
Cervical spine
Surgery
Spinal Fusion
Current management
Spinal Fractures
Cervical collar
Neurology (clinical)
business
030217 neurology & neurosurgery
Forecasting
Subjects
Details
- ISSN :
- 23800186
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Clinical Spine Surgery: A Spine Publication
- Accession number :
- edsair.doi.dedup.....cf3cfe7a18d7410f67951f8041495827