Relationship between odontoid fracture angle and cervical sagittal balance.
Angulation
Cervical spine
Dens
Fracture
Odontoid
Sagittal balance
Journal
Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836
Informations de publication
Date de publication:
2021
2021
Historique:
received:
17
11
2020
accepted:
13
03
2021
entrez:
5
5
2021
pubmed:
6
5
2021
medline:
6
5
2021
Statut:
epublish
Résumé
Fractures can occur in various locations within the odontoid process with differing orientations. However, little is known about what factors contribute to the anterior versus posterior angles/orientation of these fractures. We evaluated 74 patients with odontoid fractures (2013-2018) from a single-institution. Patients' fracture angles/orientations were measured on computed tomography studies, and were grouped into oblique posterior (OP) or oblique anterior (OA) groups. We also took into account cervical sagittal balance utilizing upright x-rays. Other variables studied included patients' ages, sagittal balance measurements, and the mechanisms of injury. Fracture angles were significantly steeper in the OP group. OP fractures had larger C2-C7 sagittal vertical axis, occiput-C2 angles, and occiput-C7 angles versus anteriorly oriented fractures. In our linear regression model, advanced age and large occiput-C2 angles were predictive of the odontoid fracture angle. Patients who sustained ground-level falls also had significantly steeper fracture angles versus those involved in motor vehicle accidents. The odontoid tends to fracture at a steep, posterior angle in elderly patients who demonstrate a large positive sagittal balance when the head is extended following a ground-level falls.
Sections du résumé
BACKGROUND
BACKGROUND
Fractures can occur in various locations within the odontoid process with differing orientations. However, little is known about what factors contribute to the anterior versus posterior angles/orientation of these fractures.
METHODS
METHODS
We evaluated 74 patients with odontoid fractures (2013-2018) from a single-institution. Patients' fracture angles/orientations were measured on computed tomography studies, and were grouped into oblique posterior (OP) or oblique anterior (OA) groups. We also took into account cervical sagittal balance utilizing upright x-rays. Other variables studied included patients' ages, sagittal balance measurements, and the mechanisms of injury.
RESULTS
RESULTS
Fracture angles were significantly steeper in the OP group. OP fractures had larger C2-C7 sagittal vertical axis, occiput-C2 angles, and occiput-C7 angles versus anteriorly oriented fractures. In our linear regression model, advanced age and large occiput-C2 angles were predictive of the odontoid fracture angle. Patients who sustained ground-level falls also had significantly steeper fracture angles versus those involved in motor vehicle accidents.
CONCLUSION
CONCLUSIONS
The odontoid tends to fracture at a steep, posterior angle in elderly patients who demonstrate a large positive sagittal balance when the head is extended following a ground-level falls.
Identifiants
pubmed: 33948327
doi: 10.25259/SNI_829_2020
pii: 10.25259/SNI_829_2020
pmc: PMC8088494
doi:
Types de publication
Journal Article
Langues
eng
Pagination
157Informations de copyright
Copyright: © 2021 Surgical Neurology International.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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