Management of Neglected Upper Cervical Spine Injuries.
C1–C2 fractures and fracture dislocation
Cervical deformity
Neglected fractures
Upper cervical spine
Journal
Indian journal of orthopaedics
ISSN: 0019-5413
Titre abrégé: Indian J Orthop
Pays: Switzerland
ID NLM: 0137736
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
20
03
2020
accepted:
06
08
2020
entrez:
17
5
2021
pubmed:
18
5
2021
medline:
18
5
2021
Statut:
epublish
Résumé
Injuries involving upper cervical spine are serious and fatal injuries which are associated with alteration of normal occipital-cervical anatomy. These injuries may result in permanent neurologic deficits or neck deformity if not treated in a timely and appropriate manner. To evaluate the outcomes of neglected upper cervical spine injuries treated by various methods. Retrospective study. Twelve patients attending ER or OPD with a history of neck trauma and who were diagnosed with fractures and fracture dislocations C1 and C2 were included in the study. Fresh injuries sustained within a week were excluded from study. The outcomes were measured in terms of improvement in VAS, ODI Scores and correction of the neck deformity. Surgical parameters like duration of surgery and blood loss were also observed. Eleven males and one female. The mean age was 40.9 ± 16.9 (07-67 years). Eleven patients underwent posterior instrumentation, while one patient was treated anteriorly. The mean delay in presentation was 28 ± 8.67 days (15-42 days). The mean duration of surgery was 188.3 ± 34.35 min (120-240 min), average blood loss was 350 ± 111.8 ml (150-600 ml). The mean VAS improved from 8.45 ± 0.89 to 3.9 ± 0.51 ( Neglected upper cervical spine injuries are difficult to treat and a posterior approach is helpful in reducing the subluxations indirectly and to obtain a posterior fusion.
Sections du résumé
BACKGROUND
BACKGROUND
Injuries involving upper cervical spine are serious and fatal injuries which are associated with alteration of normal occipital-cervical anatomy. These injuries may result in permanent neurologic deficits or neck deformity if not treated in a timely and appropriate manner.
OBJECTIVE
OBJECTIVE
To evaluate the outcomes of neglected upper cervical spine injuries treated by various methods.
STUDY DESIGN
METHODS
Retrospective study.
MATERIALS AND METHODS
METHODS
Twelve patients attending ER or OPD with a history of neck trauma and who were diagnosed with fractures and fracture dislocations C1 and C2 were included in the study. Fresh injuries sustained within a week were excluded from study. The outcomes were measured in terms of improvement in VAS, ODI Scores and correction of the neck deformity. Surgical parameters like duration of surgery and blood loss were also observed.
RESULTS
RESULTS
Eleven males and one female. The mean age was 40.9 ± 16.9 (07-67 years). Eleven patients underwent posterior instrumentation, while one patient was treated anteriorly. The mean delay in presentation was 28 ± 8.67 days (15-42 days). The mean duration of surgery was 188.3 ± 34.35 min (120-240 min), average blood loss was 350 ± 111.8 ml (150-600 ml). The mean VAS improved from 8.45 ± 0.89 to 3.9 ± 0.51 (
CONCLUSIONS
CONCLUSIONS
Neglected upper cervical spine injuries are difficult to treat and a posterior approach is helpful in reducing the subluxations indirectly and to obtain a posterior fusion.
Identifiants
pubmed: 33995872
doi: 10.1007/s43465-020-00227-y
pii: 227
pmc: PMC8081783
doi:
Types de publication
Journal Article
Langues
eng
Pagination
673-679Informations de copyright
© Indian Orthopaedics Association 2020.
Déclaration de conflit d'intérêts
Conflict of interestNone.
Références
Surg Neurol. 1999 Jun;51(6):588-94; discussion 594-5
pubmed: 10369224
J Trauma. 2002 Aug;53(2):314-20
pubmed: 12169940
Neurosurgery. 2007 Nov;61(5):987-93; discussion 993-4
pubmed: 18091276
J Neurosurg Anesthesiol. 2009 Jul;21(3):196-201
pubmed: 19542995
Spine (Phila Pa 1976). 2006 May 15;31(11):E306-13
pubmed: 16688020
J Neurosurg Spine. 2013 Aug;19(2):160-6
pubmed: 23790048
J Orthop Case Rep. 2019;9(4):80-83
pubmed: 32405495
Spine (Phila Pa 1976). 2016 Jun;41(12):E725-E732
pubmed: 26720176
J Trauma. 1993 Mar;34(3):342-6
pubmed: 8483172
Br J Neurosurg. 2015;29(4):513-9
pubmed: 25807328
J Trauma. 2007 Jul;63(1):83-9
pubmed: 17622873
Eur Spine J. 2011 Feb;20(2):195-204
pubmed: 20835875
Asian Spine J. 2014 Dec;8(6):735-46
pubmed: 25558315
J Trauma. 1991 Dec;31(12):1622-6
pubmed: 1749033
Semin Ultrasound CT MR. 2001 Aug;22(4):283-305
pubmed: 11513156
J Neurosurg Spine. 2005 Apr;2(4):505-9
pubmed: 15871495
J Trauma. 1987 Sep;27(9):980-6
pubmed: 3656481
Clin Orthop Relat Res. 2005 Feb;(431):93-103
pubmed: 15685061
Injury. 2010 Nov;41(11):1127-35
pubmed: 20889154
Clin Spine Surg. 2016 Jun;29(5):E240-5
pubmed: 22874473
Brain. 1972;95(1):87-100
pubmed: 5023093
Int J Clin Exp Med. 2015 Jun 15;8(6):8571-80
pubmed: 26309508
Neurol India. 2017 Mar-Apr;65(2):341-347
pubmed: 28290397
J Bone Joint Surg Am. 1979 Dec;61(8):1119-42
pubmed: 511875
J Spinal Disord Tech. 2010 Apr;23(2):113-20
pubmed: 20051922