Mortality, complication, and fusion rates of patients with odontoid fracture: the impact of age and comorbidities in 204 cases

Charles, Yann Philippe; Ntilikina, Yves; Blondel, Benjamin; Fuentès, S.; Allia, Jérémy; Bronsard, Nicolas; Lleu, Maxime; Nicot, Benjamin; Challier, Vincent; Godard, J.; Kouyoumdjïan, Pascal; Lonjon, Nicolas; Marinho, Paulo Vinícius Tertuliano; Berthiller, Julien; Freitas, Eurico; Barrey, Cédric

doi:10.1007/s00402-018-3050-6

Cited by 28 publications

(24 citation statements)

References 26 publications

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“…20 La participación de varios cirujanos de columna es también una de las fortalezas, ya que cada uno de los pacientes es sometido a un consenso para valorar su manejo, más aún existe la posibilidad de variación en el tratamiento, inclusive en patrones de fractura similares siendo difícil controlar la indicación quirúrgica y la elección del tratamiento debido a los hallazgos en el paciente y la decisión del manejo. 21,22 Nuestro estudio aporta la descripción de técnicas utilizadas en nuestro medio con un nivel de aplicación amplia y reproducible. En el análisis de la bibliografía existen claras tendencias que indican formas de mejorar los resultados quirúrgicos en pacientes con fracturas de odontoides, siendo el manejo principal en la actualidad.…”

Section: Discussionunclassified

Fractura de odontoides: tratamiento, pronóstico y morbimortalidad asociada en un Hospital de Alta Concentración

Piña¹

2021

Ortho-Tips

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Section: Discussionunclassified

Fractura de odontoides: tratamiento, pronóstico y morbimortalidad asociada en un Hospital de Alta Concentración

Piña¹

2021

Ortho-Tips

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“…Axis body fracture, as well as odontoid and pedicle fractures, may cause atlantoaxial instability which may cause neck pain and stiffness, activity limitation, and progressive compression of the spinal cord. [23,24] Atlantoaxial instability caused by C2 fractures need surgical reduction and stabilization to limit the anterior displacement of atlas effectively and enhance the atlantoaxial sagittal stability to prevent further spinal cord injury. [25,14] Because of the anatomical peculiarity of the axis and the complexity of injury pathology, clinical management of the axis fractures was hard work for spine surgeon.…”

Section: Discussionmentioning

confidence: 99%

Cervical pedicle screws fixation treatment the atlantoaxial instability of axis burst fractures

Yan¹,

Zhang²,

Zhang

2020

Preprint

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BackgroundAlthough the cervical pedicle screws and rods were used for atlantoaxial instable, the axis fractures still a challenge for spine surgeon. ObjectiveThis study was to evaluated the clinical outcomes of axis burst fractures had C1C3 pedicles screws fixation treatment. MethodsFrom June 2014 to July 2018, 45 patients with axis fractures were enrolled in this study; 23 patients was odontoid underwent C1C2 pedicles screws fixation, and 21 patients was odontoid combine body fractures had C1C3 pedicles screws fixation. The clinical outcomes of pain relief (visual analog scale, VAS), functional disability (neck disability index, NDI) were recorded at baseline and at the final follow-up. ResultsThe pain index and NDI were all significantly improved when compared to pretreatment (P < 0.01).The VAS and ND were no significant difference between two groups (P > 0.05). All patients, suffered from severe mechanical upper cervical neck pain at pre-operative, were pain free post-operation. Preoperative neurological examination was normal in all patients, and remained the same after surgery.All cases showed normal neurological function at the final follow-up. No vascular or neurological complication was noted. The fracture healing and the bony union of the fixed segments were revealed in all cases on CT views. Implant failure and instability were not seen on lateral flexion/extension radiographs of the cervical spine. ConclusionsCervical pedicle screws fixation was effective and safe procedures in the treatment of traumatic spondylolisthesis of axial fractures. The atlantoaxial instable of axis burst fractures can be managed with C1-C3 pedicles screws fixation. AcknowledgementsWe sincerely appreciated the genial help from all scholars who contributed to our research. AbbreviationsVAS: visual analog scale NDI: neck disability index 9 CT: computer tomography MRI: magnetic resonance imaging

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“…For every patient, the following data were prospectively collected: age, gender, comorbidities, smoking status, diabetes diagnosis, T-score for bone densitometry (dual-energy x-ray absorptiometry scan; < 2.5 was considered the cutoff for osteoporosis; examinations from the year prior to or performed in the 12 months following the injury were considered), treatment timing after injury, fracture diastasis (distance between fracture rims) and odontoid process angulation 17 (odontoid deviation from the ideal alignment was considered as favorable or unfavorable according to its severity, > 10° or < 10°) on the pre-and postoperative CT scans, follow-up length, union or nonunion status on CT, and segmental stability or residual instability on dynamic radiographs at last follow-up evaluation. The radiological evaluation was performed by one senior radiologist from each contributing institution.…”

Section: Data Collection and Outcome Measurementmentioning

confidence: 99%

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study

Ricciardi

Trungu

Scerrati

et al. 2021

Journal of Neurosurgery: Spine

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OBJECTIVEAnderson type II odontoid fractures are severe conditions, mostly affecting elderly people (≥ 70 years old). Surgery can be performed as a primary treatment or in cases of failed conservative management. This study aimed to investigate how duration from injury to surgery, as well as clinical, radiological, and surgical risk factors, may influence the union rate after anterior odontoid screw placement for Anderson type II odontoid fractures.METHODSThe authors conducted a retrospective multicenter study. Demographic, clinical, surgical, and radiological data of patients who underwent anterior odontoid screw placement for Anderson type II fractures were retrieved from institutional databases. Study exclusion criteria were prolonged corticosteroid drug therapy (> 4 weeks), polytraumatic injuries, oncological diagnosis, and prior cervical spine trauma.RESULTSEighty-five patients were included in the present investigation. The union rate was 76.5%, and 73 patients (85.9%) did not report residual instability. Age ≥ 70 years (p < 0.001, OR 6), female gender (p = 0.016, OR 3.61), osteoporosis (p = 0.009, OR 4.02), diabetes (p = 0.056, OR 3.35), fracture diastasis > 1 mm (p < 0.001, OR 8.5), and duration from injury to surgery > 7 days (p = 0.002, OR 48) independently influenced union rate, whereas smoking status (p = 0.677, OR 1.24) and odontoid process angulation > 10° (p = 0.885, OR 0.92) did not.CONCLUSIONSAlthough many factors have been reported as influencing the union rate after anterior odontoid screw placement for Anderson type II fractures, duration from injury to surgery > 7 days appears to be the most relevant, resulting in a 48 times higher risk for nonunion. Early surgery appears to be associated with better radiological outcomes, as reported by orthopedic surgeons in other districts. Prospective comparative clinical trials are needed to confirm these results.

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Mortality, complication, and fusion rates of patients with odontoid fracture: the impact of age and comorbidities in 204 cases

Cited by 28 publications

References 26 publications

Fractura de odontoides: tratamiento, pronóstico y morbimortalidad asociada en un Hospital de Alta Concentración

Fractura de odontoides: tratamiento, pronóstico y morbimortalidad asociada en un Hospital de Alta Concentración

Cervical pedicle screws fixation treatment the atlantoaxial instability of axis burst fractures

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study

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