Back to Search
Start Over
Management and long-term outcome of type II acute odontoid fractures: a population-based consecutive series of 282 patients
- Source :
- The Spine Journal. 21:627-637
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- BACKGROUND CONTEXT The surgical fixation rate of type II odontoid fracture (OFx) in the elderly (≥65 years) is much lower than expected if the treatment adheres to current general treatment recommendations. Outcome data after conservative treatment for elderly patients with these fractures are sparse. PURPOSE The main aim of this study was to determine the long-term outcome after conservative and surgical treatments of type II OFx (all age-groups) to evaluate whether nonoperative treatment yields an acceptable outcome. STUDY DESIGN/SETTING Retrospective study based on a prospective database. PATIENT SAMPLE Two hundred eighty-two consecutive patients with type II OFx treated at Oslo University Hospital over an 8-year period. OUTCOME MEASURES Long-term rates of bony fusion, fibrous union, pseudarthrosis, crossover from primary conservative treatment to surgical fixation, new-onset spinal cord injury (SCI), and neck pain were the outcome measures used. METHODS The present study was based on data extracted from our quality control database for acute cervical spine fractures. All ages were included. In addition, long-term follow-up of alive patients was performed during the years 2018–2019. The follow-up included neurological examination, radiological examination, and scoring of bony fusion status, crossover from primary conservative treatment to surgical fixation, new-onset SCI, neck pain, and Neck Disability Index (NDI score). Data are described by counts, percentages, medians, means, ranges and standard deviations where appropriate. For statistical analyses the Mann-Whitney U test, Wilcoxon signed-rank test, and t tests were used. RESULTS During the eight-year study period, we registered 282 consecutive patients with type II OFx; 54% were males, patient age ranged from 15 to 101 years, 84% were ≥65 years of age (WHO definition of elderly), and 51% were ≥80 years of age. Severe comorbidities (American Society of Anesthesiologists, ASA ≥3) were seen in 67%, whereas nonindependent living was registered in 32%. Severe comorbidities and nonindependent living were significantly associated with increasing age (p
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Neurological examination
Context (language use)
Young Adult
03 medical and health sciences
0302 clinical medicine
Odontoid Process
medicine
Humans
Orthopedics and Sports Medicine
Spinal cord injury
Aged
Retrospective Studies
Fixation (histology)
Aged, 80 and over
030222 orthopedics
Neck pain
medicine.diagnostic_test
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
Surgery
Radiography
Pseudarthrosis
Treatment Outcome
Mann–Whitney U test
Spinal Fractures
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15299430
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- The Spine Journal
- Accession number :
- edsair.doi.dedup.....fbecda6dee5008e77eb055a6cd933083