Immobilisation in occipital condyle fractures: A systematic review

Musbahi, Omar; Khan, Ameer; Anwar, Mohammed Omer; Chaudery, Hannan; Ali, Adam M.; Montgomery, Alexander

doi:10.1016/j.clineuro.2018.08.013

Cited by 12 publications

(11 citation statements)

References 37 publications

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“…6 The small amount of cases explains the variety of different treatment recommendations, ranging from conservative therapy with neck immobilization to surgical fusion (level III evidence). 7 In a retrospective study (n = 23), Byström et al, 8 using the Mueller classification, found no unstable patients. Consequently, they recommended 6 weeks treatment with nonrigid orthosis (cervical collar) for unilateral OCF, or a more rigid external immobilization in a halo-vest device for bilateral OCF both without AOD (level III recommendation).…”

Section: Occipital Condyle Fractures: Classification and Managementmentioning

confidence: 96%

Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations

et al. 2020

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Section: Occipital Condyle Fractures: Classification and Managementmentioning

confidence: 96%

Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations

et al. 2020

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“…Classifications of OCF are based on the CT images of the cranio-cervical junction (CCJ) and MRI [2]. The Anderson-Montesano and Tuli classifications are the types which are most commonly used in these cases [1,[4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures

Tomaszewski

Kler²,

Pethe³

et al. 2021

J Orthop Surg Res

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Background Occipital condyle fractures (OCFs) in patients before 18 years of age are rare. Classifications of OCF are based on the CT images of the cranio-cervical junction (CCJ) and MRI. The Anderson-Montesano and Tuli classifications are the types which are most commonly used in these cases. Classification of OCFs allows the implementation of OCF treatment. The aim of this study was to evaluate the effectiveness of using the OCF classification in pediatric patients based on the analysis of our own cases. Methods During the years 2013–2020, 6 pediatric patients with OCFs, aged 14–18, have been treated. Two patients with unstable fracture III according to Anderson-Montesano and IIB according to Tuli were treated with the halo-vest. Additionally, one patient presenting neurological symptoms and with an associated C1 fracture was qualified for the halo-vest stabilization as well. The other patients were treated with a Minerva collar. We evaluated the results 6 months after completing the OCF treatment using the Neck Disability Index (NDI) and SF-36 questionnaires. Confidence intervals for the mean values were verified using the MeanCI function (from the R library DescTools) for both classical and bootstrap methods. Results Based on NDI results, we have obtained in our patients an average of 4.33/45 points (2–11) and 9.62% (4.4–24.4). Based on the SF-36 questionnaire, we obtained an average of 88.62% (47.41–99.44). Conclusion The Anderson-Montesano and Tuli’s classifications of OCF can be used to assess the stability of OCF in adolescents, but both classifications should be used simultaneously. CT and MR imaging should be used in diagnosing OCFs, whereas CT allows assessing therapeutic outcomes in OCF.

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“…The current practice guidelines typically support management of patients with OCF with a cervical collar for approximately 6 weeks or longer. [ 4 , 11 , 16 ] Most sources recommend a semi-rigid collar for stable injury and rigid immobilization for a potentially unstable injury. [ 12 ] This is largely based on expert opinion from case studies or case series.…”

Section: Introductionmentioning

confidence: 99%

Isolated traumatic occipital condyle fractures: Is external cervical orthosis even necessary?

Nwachuku

Njoku-Austin

Patel

et al. 2021

Surgical Neurology International

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Background: Occipital condyle fractures (OCFs) have been reported in up to 4–16% of individuals suffering cervical spine trauma. The current management of OCF fractures relies on a rigid cervical collar for 6 weeks or longer. Here, we calculated the rate of acute and delayed surgical intervention (occipitocervical fusion) for patients with isolated OCF who were managed with a cervical collar over a 10-year period at a single institution. Methods: This was a retrospective analysis performed on all patients admitted to a Level 1 Trauma Center between 2008 and 2018 who suffered traumatic isolated OCF managed with an external rigid cervical orthosis. Radiographic imaging was reviewed by several board-certified neuroradiologists. Demographic and clinical data were collected including need for occipitocervical fusion within 12 months after trauma. Results: The incidence of isolated OCF was 4% (60/1536) for those patients admitted with cervical spine fractures. They averaged 49 years of age, and 58% were male falls accounted for the mechanism of injury in 47% of patients. Classification of OCF was most commonly classified in 47% as type I Anderson and Montesano fractures. Of the 60 patients who suffered isolated OCF that was managed with external cervical orthosis, 0% required occipitocervical fusion within 12 months posttrauma. About 90% were discharged, while the remaining 10% sustained traumatic brain/orthopedic injury that limited an accurate neurological assessment. Conclusion: Here, we documented a 4% incidence of isolated OCF in our cervical trauma population, a rate which is comparable to that found in the literature year. Most notably, we documented a 0% incidence for requiring delayed occipital-cervical fusions.

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Immobilisation in occipital condyle fractures: A systematic review

Cited by 12 publications

References 37 publications

Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations

Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations

Evaluation of using the Anderson-Montesano and the Tuli classifications in pediatric patients with occipital condyle fractures

Isolated traumatic occipital condyle fractures: Is external cervical orthosis even necessary?

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