Early Complications of Surgical Versus Conservative Treatment of Isolated Type II Odontoid Fractures in Octogenarians

2008 ◽  
Vol 21 (8) ◽  
pp. 535-539 ◽  
Author(s):  
Harvey E. Smith ◽  
Stewart M. Kerr ◽  
Mitchell Maltenfort ◽  
Sonia Chaudhry ◽  
Robert Norton ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Type Ii ◽  
Early Complications ◽  
Odontoid Fractures

scholarly journals Surgery vs conservative treatment for type II and III odontoid fractures in a geriatric population

Medicine ◽  
2019 ◽  
Vol 98 (44) ◽  
pp. e10281 ◽  
Author(s):  
Lei Fan ◽  
Dingqiang Ou ◽  
Xuna Huang ◽  
Mao Pang ◽  
Xiu-Xing Chen ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Type Ii ◽  
Geriatric Population ◽  
Odontoid Fractures

scholarly journals Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction

2016 ◽  
Vol 14 (4) ◽  
pp. 528-533
Author(s):  
Luiz Adriano Esteves ◽  
◽  
Andrei Fernandes Joaquim ◽  
Helder Tedeschi ◽  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Case Series ◽  
Craniocervical Junction ◽  
Data Sets ◽  
Type Ii ◽  
Surgical Wound ◽  
Traumatic Injuries ◽  
Odontoid Fractures ◽  
Posterior Elements

ABSTRACT Objective To evaluate the correlation between the treatment, the characteristics of the lesions and the clinical outcome of patients with traumatic injuries to the craniocervical junction. Methods This was a retrospective study of patients treated conservatively or surgically between 2010 and 2013 with complete data sets. Results We analyzed 37 patients, 73% were men with mean age of 41.7 years. Of these, 32% were submitted to initial surgical treatment and 68% received conservative treatment. Seven (29%) underwent surgery subsequently. In the surgical group, there were seven cases of odontoid type II fractures, two cases of fracture of posterior elements of the axis, one case of C1-C2 dislocation with associated fractured C2, one case of occipitocervical dislocation, and one case of combined C1 and C2 fractures, and facet dislocation. Only one patient had neurological déficit that improved after treatment. Two surgical complications were seen: a liquoric fistula and one surgical wound infection (reaproached). In the group treated conservatively, odontoid fractures (eight cases) and fractures of the posterior elements of C2 (five cases) were more frequent. In two cases, in addition to the injuries of the craniocervical junction, there were fractures in other segments of the spine. None of the patients who underwent conservative treatment presented neurological deterioration. Conclusion Although injuries of craniocervical junction are relatively rare, they usually involve fractures of the odontoid and the posterior elements of the axis. Our results recommend early surgical treatment for type II odontoid fractures and ligament injuries, the conservative treatment for other injuries.

Conservative treatment for Landells and Van Peteghem type II atlas fracture accompanied with atlantoaxial rotatory subluxation

2015 ◽  
Vol 15 (11) ◽  
pp. e31-e33
Author(s):  
Da-Geng Huang ◽  
Ding-Jun Hao ◽  
Zhen Chang ◽  
Bao-Rong He ◽  
Tuan-Jiang Liu
Keyword(s):  
Conservative Treatment ◽  
Type Ii ◽  
Atlas Fracture ◽  
Rotatory Subluxation

Surgical Treatment of Unstable Type II Odontoid Fractures in Skeletally Mature Individuals

Spine ◽  
2010 ◽  
Vol 35 (Supplement) ◽  
pp. S209-S218 ◽  
Author(s):  
Alpesh A. Patel ◽  
Ron Lindsey ◽  
Jason T. Bessey ◽  
Jens Chapman ◽  
Raja Rampersaud
Keyword(s):  
Surgical Treatment ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Unstable Type

scholarly journals Case Report: Clinical Features of Congenital Portosystemic Shunts in the Neonatal Period

2021 ◽  
Vol 9 ◽  
Author(s):  
Suhua Xu ◽  
Peng Zhang ◽  
Liyuan Hu ◽  
Wenhao Zhou ◽  
Guoqiang Cheng
Keyword(s):  
Liver Transplantation ◽  
Conservative Treatment ◽  
Liver Enzyme ◽  
Neonatal Period ◽  
Elevated Liver Enzyme ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Type Ii ◽  
Neonatal Cholestasis ◽  
Portosystemic Shunts

Objective: The aim of this single-center retrospective study was to analyze the clinical characteristics, treatment options, and course of neonatal-onset congenital portosystemic shunts (CPSS).Methods: We included all patients with CPSS who presented with clinical symptoms within the neonatal period in our institution between 2015 and 2020.Results: Sixteen patients were identified, including 13 patients with intrahepatic portosystemic shunts (IPSS) and three patients with extrahepatic portosystemic shunts (EPSS). The median age of diagnosis was 16 days (range prenatal 24 weeks−12 months). Hyperammonemia (60%), neonatal cholestasis (44%), elevated liver enzyme (40%), hypoglycemia (40%), thrombocytopenia (38%), and coagulation abnormalities (23%) appeared in neonatal CPSS. Twelve patients (75%) presented with congenital anomalies, of which congenital heart disease (CHD) (44%) was the most common. Thirteen patients with IPSS initially underwent conservative treatment, but two of them were recommended for the catheter interventional therapy and liver transplantation, respectively, due to progressive deterioration of liver function. Spontaneous closure occurred in nine patients with IPSS. The shunt was closed using transcatheter embolization in one patient with EPSS type II. Another patient with EPSS type II underwent surgical treatment of CHD firstly. The remaining patient with EPSS type Ib received medical therapy and refused liver transplantation.Conclusion: Hyperammonemia, neonatal cholestasis, elevated liver enzyme, hypoglycemia, and thrombocytopenia are the main complications of neonatal CPSS. Moreover, CPSS is associated with multiple congenital abnormalities, especially CHD. Intrahepatic portosystemic shunts may close spontaneously, and conservative treatment can be taken first. Extrahepatic portosystemic shunts should be closed to prevent complications.

Anterior fixation of odontoid fractures in an elderly population

2010 ◽  
Vol 12 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Andrew T. Dailey ◽  
David Hart ◽  
Michael A. Finn ◽  
Meic H. Schmidt ◽  
Ronald I. Apfelbaum
Keyword(s):  
Elderly Population ◽  
Odontoid Process ◽  
Feeding Tube ◽  
Type Ii ◽  
Single Institution ◽  
Odontoid Fractures ◽  
Single Screw ◽  
Flexion Extension ◽  
Fracture Nonunion

Object Fractures of the odontoid process are the most common fractures of the cervical spine in patients over the age of 70 years. The incidence of fracture nonunion in this population has been estimated to be 20-fold greater than that in patients under the age of 50 years if surgical stabilization is not used. Anterior and posterior approaches have both been advocated, with excellent results reported, but surgeons should understand the drawbacks of the various techniques before employing them in clinical practice. Methods A retrospective review was undertaken to identify patients who had direct fixation of an odontoid fracture at a single institution from 1991 to 2006. Patients were followed up using flexion-extension radiographs, and stability was evaluated as bone union, fibrous union, or nonunion. Patients with bone or fibrous union were classified as stable. In addition, the incidence of procedure- and nonprocedure-related complications was extracted from the medical record. Results Of the 57 patients over age 70 who underwent placement of an odontoid screw, 42 underwent follow-up from 3 to 62 months (mean 15 months). Stability was confirmed in 81% of these patients. In patients with fixation using 2 screws, 96% demonstrated stability on radiographs at final follow-up. Only 56% of patients with fixation using a single screw demonstrated stability on radiographs. In the immediate postoperative period, 25% of patients required a feeding tube and 19% had aspiration pneumonia that required antibiotic treatment. Conclusions Direct fixation of Type II odontoid fractures showed stability rates > 80% in this challenging population. Significantly higher stabilization rates were achieved when 2 screws were placed. The anterior approach was associated with a relatively high dysphagia rate, and patients must be counseled about this risk before surgery.

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