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Odontoid fracture

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https://www.readbyqxmd.com/read/29155062/fusion-failure-fatality-long-term-outcomes-after-surgical-versus-nonoperative-management-of-type-ii-odontoid-fracture-in-octogenarians
#1
Avital Perry, Christopher S Graffeo, Lucas P Carlstrom, Wendy Chang, Grant W Mallory, Ross C Puffer, Michelle J Clarke
INTRODUCTION: Type II odontoid fracture is a highly morbid injury among octogenarians, with 41% one-year mortality. Our objective was to assess long-term fusion, complication, and survival rates. METHODS: Retrospective review of prospective trauma registry. Blinded review of follow-up radiographs. RESULTS: Follow-up cohort included 94 nonoperative and 17 operative patients (median 52 and 79 months). Operative group had significantly higher rates of repeat surgery for primary treatment failure or complication (1% vs...
November 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29154124/the-effectiveness-and-clinical-outcomes-of-the-minerva-cervical-thoracic-jacket-in-patients-with-type-ii-odontoid-fractures
#2
Sait Öztürk, Fatih Serhat Erol, Bekir Akgün, Metin Kaplan
Background/aim: The objective of this study was to carry out a detailed analysis and assess the outcomes for the Minerva cervical thoracic jacket (CTJ) in patients with type II odontoid fractures who could not be surgically treated. Materials and methods: Twenty-six patients for whom the Minerva CTJ was used rather than surgery for different reasons were included in the study. All patients were fitted with the Minerva CTJ within the first 24 h following diagnosis. The patients were followed 4 weeks after hospital discharge and then at 2-week intervals...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29145253/anterior-endoscopically-assisted-bone-grafting-for-iatrogenic-distraction-of-odontoid-fracture-after-percutaneous-anterior-screw-fixation-a-case-report
#3
Ze-Xin Chen, Hui Zhang, Nai-Feng Tian, Xiang-Yang Wang, Yan Lin, Yao-Sen Wu
RATIONALE: The complication of iatrogenic distraction of odontoid fracture after anterior screw fixation has not been reported in the literature. We treated the patient with endoscopically assisted bone grafting with good results. The new technique was not reported in the management of odontoid fracture or nonunion before. PATIENT CONCERNS: A 22-year-old man presented with neck pain after a motorcycle crash. The cervical spine radiograph and computed tomographic scan demonstrated the base of dens displaced 2 mm anteriorly...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095313/treatment-of-type-ii-odontoid-fracture-with-a-novel-technique-titanium-cable-dragged-reduction-and-cantilever-beam-internal-fixation
#4
Ce Zhu, Lei Wang, Hao Liu, Yueming Song, Limin Liu, Tao Li, Quan Gong
Surgical methods for type II odontoid fracture can be classified into 2 main groups: anterior or posterior approach. A more effective way to achieve bone fusion with the lowest possible surgical risk is needed. Therefore, the aim of our study was to describe and evaluate a novel technique, cable-dragged reduction/cantilever beam internal fixation for the treatment of type II odontoid fracture.This was a retrospective study enrolled 34 patients underwent posterior cable-dragged reduction/cantilever-beam internal fixation surgery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29063167/-management-and-outcome-of-type-ii-fractures-of-the-odontoid-process
#5
Carolin Meyer, Johannes Oppermann, Ingo Meermeyer, Peer Eysel, Lars Peter Müller, Gregor Stein
BACKGROUND: The most effective treatment of type II dens fractures according to Anderson and D'Alonzo remains controversial as there is no guidance on the choice of conservative or surgical therapy and if the anterior or the posterior approach is more advantageous. In 1993 Eysel and Roosen showed that the consolidation rate of type II odontoid fractures mostly depends on the morphology of the fracture and established a classification with corresponding treatment recommendations. OBJECTIVE: The investigation aimed at clarifying the outcome of type II dens fractures treated according to the recommendations of Eysel and Roosen...
October 23, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29053084/intubation-biomechanics-validation-of-a-finite-element-model-of-cervical-spine-motion-during-endotracheal-intubation-in-intact-and-injured-conditions
#6
Benjamin C Gadomski, Snehal S Shetye, Bradley J Hindman, Franklin Dexter, Brandon G Santoni, Michael M Todd, Vincent C Traynelis, Robert P From, Ricardo B Fontes, Christian M Puttlitz
OBJECTIVE Because of limitations inherent to cadaver models of endotracheal intubation, the authors' group developed a finite element (FE) model of the human cervical spine and spinal cord. Their aims were to 1) compare FE model predictions of intervertebral motion during intubation with intervertebral motion measured in patients with intact cervical spines and in cadavers with spine injuries at C-2 and C3-4 and 2) estimate spinal cord strains during intubation under these conditions. METHODS The FE model was designed to replicate the properties of an intact (stable) spine in patients, C-2 injury (Type II odontoid fracture), and a severe C3-4 distractive-flexion injury from prior cadaver studies...
October 20, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29040717/letter-reconsidering-bone-morphogenetic-protein-in-the-cervical-spine-selective-use-for-managing-type-ii-odontoid-fractures-in-the-elderly
#7
Francis J Jareczek, Kingsley O Abode-Iyamah, Efrem M Cox, Nader S Dahdaleh, Patrick W Hitchon, Matthew A Howard
No abstract text is available yet for this article.
October 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29021682/spontaneous-regression-of-retro-odontoid-post-traumatic-cicatrix-following-occipitocervical-fixation
#8
Priyank Sinha, Ming-Te Lee, Sasan Panbehchi, Ankur Saxena, Debasish Pal
This case report describes a patient who presented with myelopathy secondary to a large retro-odontoid post traumatic cicatrix. The objective of this study was to discuss the clinical presentation, pathogenesis, imaging, and surgical management of pseudoarthrosis tissue mass associated with odontoid nonunion. Atlantoaxial subluxation (AAS) has been widely reported in patients with rheumatoid arthritis. AAS leads to repeated cycles of partial tear and repair of ligaments around the altantoaxial complex, resulting in the formation of periodontoid mass (pseudotumor)...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29017980/predisposing-factors-of-fracture-nonunion-after-posterior-c1-lateral-mass-screws-combined-with-c2-pedicle-laminar-screws-fixation-for-type-ii-odontoid-fracture
#9
Hui Wang
INTRODUCTION: The aim of this study was to explore the predisposing factors for fracture nonunion after C1 lateral screw combined with C2 pedicle/laminar screw for type II odontoid fracture, and hope to provide references in decision making and surgical planning for spinal surgeons. METHODS: This is a retrospective study. By retrieving the medical records from January 2010 to July 2015 in our hospital, 117 type II odontoid fracture patients were reviewed. According to the occurrence of fracture union at the final follow up, patients were divided into two groups: Union group and Non-union group...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28962628/percutaneous-anterior-c1-2-transarticular-screw-fixation-salvage-of-failed-percutaneous-odontoid-screw-fixation-for-odontoid-fracture
#10
Ai-Min Wu, Hai-Ming Jin, Zhong-Ke Lin, Yong-Long Chi, Xiang-Yang Wang
BACKGROUND: The objective of this study is to investigate the outcomes and safety of using percutaneous anterior C1/2 transarticular screw fixation as a salvage technique for odontoid fracture if percutaneous odontoid screw fixation fails. METHODS: Fifteen in 108 odontoid fracture patients (planned to be treated by percutaneous anterior odontoid screw fixation) were failed to introduce satisfactory odontoid screw trajectory. To salvage this problem, we chose the percutaneous anterior C1/2 transarticular screw fixation technique in treatment of these patients...
September 29, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28922277/percutaneous-posterior-trans-articular-atlantoaxial-fixation-for-the-treatment-of-odontoid-fractures-in-the-elderly-a-prospective-study
#11
Mohamed Alhashash, Mootaz Shousha, Hany Gendy, Ahmed Samir Barakat, Heinrich Boehm
STUDY DESIGN: A prospective study of 20 multimorbid patients older than 65 years undergoing minimally invasive surgical treatment for odontoid fracture. OBJECTIVES: To analyze the results of percutaneous transarticular atlantoaxial screw fixation as a new minimally invasive treatment modality in this high risk group of patients. SUMMARY OF BACKGROUND DATA: Odontoid fractures are a common injury pattern in the elderly. These fractures typically present significant challenges as geriatric patients often have multiple comorbidities that may adversely affect fracture management...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28902102/post-traumatic-spinal-hygroma-causing-cord-compression-in-type-iii-odontoid-fracture-with-vertical-atlantoaxial-instability
#12
Salvatore Russo, Antonio Belli, Andy Eynon, Ali Nader-Sepahi
STUDY DESIGN: Case report. OBJECTIVE: To report the first case in the literature of a traumatic cervical spine subdural cerebrospinal fluid (CSF) collection (hygroma) under tension causing cord compression. We suggest etiopathogenesis and modality of treatment. SUMMARY OF BACKGROUND DATA: Hygromas are subdural cranial CSF collection. A literature review showed no previous published case of post-traumatic spinal hygroma. This was a potential life-threatening sequelae of a high cervical injury that warranted early diagnosis and emergency treatment...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28881111/biomechanical-comparison-of-inter-fragmentary-compression-pressures-lag-screw-versus-herbert-screw-for-anterior-odontoid-screw-fixation
#13
Jin-Woo Park, Kyoung-Tae Kim, Joo-Kyung Sung, Seong-Hyun Park, Ki-Woong Seong, Dae-Chul Cho
OBJECTIVE: The purpose of the present study was to compare inter-fragmentary compression pressures after fixation of a simulated type II odontoid fracture with the headless compression Herbert screw and a half threaded cannulated lag screw. METHODS: We compared inter-fragmentary compression pressures between 40- and 45-mm long 4.5-mm Herbert screws (n=8 and n=9, respectively) and 40- and 45-mm long 4.0-mm cannulated lag screws (n=7 and n=10, respectively) after insertion into rigid polyurethane foam test blocks (Sawbones, Vashon, WA, USA)...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28864483/cadaveric-study-of-movement-in-the-unstable-upper-cervical-spine-during-emergency-management-tracheal-intubation-and-cervical-spine-immobilisation-a-study-protocol-for-a-prospective-randomised-crossover-trial
#14
Shiyao Liao, Erik Popp, Petra Hüttlin, Frank Weilbacher, Matthias Münzberg, Niko Schneider, Michael Kreinest
INTRODUCTION: Emergency management of upper cervical spine injuries often requires cervical spine immobilisation and some critical patients also require airway management. The movement of cervical spine created by tracheal intubation and cervical spine immobilisation can potentially exacerbate cervical spinal cord injury. However, the evidence that previous studies have provided remains unclear, due to lack of a direct measurement technique for dural sac's space during dynamic processes...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28826707/modified-posterior-c1-lateral-mass-screw-insertion-for-type-ii-odontoid-process-fractures-using-intraoperative-computed-tomography-based-spinal-navigation-to-minimize-postoperative-occipital-neuralgia
#15
Basem Ishak, Till Schneider, R Shane Tubbs, Valerie Gimmy, Alexander Younsi, Andreas W Unterberg, Karl L Kiening
BACKGROUND: Various surgical techniques have been described for treating odontoid instability and achieving effective stabilization. The earliest technique to be described proposed a C1 lateral mass entry point including neurectomy of the C2 nerve roots to ensure hemostasis. Because C2 neurectomy remains controversial, preservation of the C2 nerve root as described in Goel-Harms technique can lead to intractable occipital neuralgia and significant blood loss. The aim of this study was to modify the Goel-Harms technique with a high C1 lateral mass screw entry point to enhance overall intraoperative safety...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28820364/patterns-of-c-2-fracture-in-the-elderly-comparison-of-etiology-treatment-and-mortality-among-specific-fracture-types
#16
Ingrid Radovanovic, Jennifer C Urquhart, Parham Rasoulinejad, Kevin R Gurr, Fawaz Siddiqi, Christopher S Bailey
OBJECTIVE Previous studies have focused on Type II odontoid fractures and have failed to report on the effect of other C-2 fracture types on treatment and outcome. The purpose of this study was to compare patient characteristics, cause of injury, predisposing factors to fracture, treatments, and mortality rates among C-2 fracture types in a cohort of elderly patients 70 years of age and older. METHODS A retrospective cohort study design was used. Patients who sustained a C-2 fracture between 2002 and 2011 and who were admitted to the authors' Level 1 trauma center were identified using the Discharge Abstract Database and the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code S12...
November 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28816879/atlas-fractures-and-atlas-osteosynthesis-a-comprehensive-narrative-review
#17
Frank Kandziora, Jens R Chapman, Alexander R Vaccaro, Gregory D Schroeder, Matti Scholz
Most atlas fractures are the result of compression forces. They are often combined with fractures of the axis and especially with the odontoid process. Multiple classification systems for atlas fractures have been described. For an adequate diagnosis, a computed tomography is mandatory. To distinguish between stable and unstable atlas injury, it is necessary to evaluate the integrity of the transverse atlantal ligament (TAL) by magnetic resonance imaging and to classify the TAL lesion. Studies comparing conservative and operative management of unstable atlas fractures are unfortunately not available in the literature; neither are studies comparing different operative treatment strategies...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816875/controversies-in-the-management-of-geriatric-odontoid-fractures
#18
Scott C Wagner, Gregory D Schroeder, Christopher K Kepler, Alexander J Schupper, Frank Kandziora, Emiliano N Vialle, Cumhur Oner, Michael G Fehlings, Alexander R Vaccaro
Fractures of the odontoid process of C2 have become increasingly prevalent in the aging population and are typically associated with a high incidence of morbidity. Dens fractures comprise the majority of all cervical fractures in patients older than 80 years and remain the most common cervical fracture pattern in all geriatric patients. Type II odontoid fractures have been associated with limited healing potential, and both nonoperative and operative management are associated with high mortality rates. Historically, there has been some debate in the literature with regards to optimal management strategies to maximize outcomes in geriatric patients...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816869/spine-trauma-what-are-the-current-controversies
#19
Cumhur Oner, Shanmuganathan Rajasekaran, Jens R Chapman, Michael G Fehlings, Alexander R Vaccaro, Gregory D Schroeder, Said Sadiqi, James Harrop
Although less common than other musculoskeletal injuries, spinal trauma may lead to significantly more disability and costs. During the last 2 decades there was substantial improvement in our understanding of the basic patterns of spinal fractures leading to more reliable classification and injury severity assessment systems but also rapid developments in surgical techniques. Despite these advancements, there remain unresolved issues concerning the management of these injuries. At this moment there is persistent controversy within the spinal trauma community, which can be grouped under 6 headings...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28789999/trends-in-the-surgical-management-of-odontoid-fractures-in-patients-above-75-years-of-age-retrospective-study-of-70-cases
#20
A Faure, T Graillon, S Pesenti, P Tropiano, B Blondel, S Fuentes
BACKGROUND: Odontoid fractures are the most common upper cervical spine fracture in adults over 70 years of age. Hence, treatment of these fractures has public health implications. OBJECTIVES: Evaluate the early complications, bone healing and mortality in patients above 75 years of age who undergo surgical treatment of an odontoid fracture. Compare the results between patients operated with the Harms technique or anterior screw fixation. METHODS: This was a retrospective study of 70 patients with an odontoid fracture who were treated surgically between 2000 and 2015 at the Hôpital de la Timone in France...
August 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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