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.

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 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 Type II Odontoid Fractures Case Series: History of Seizures a Risk Factor for Failure of Non-operative Treatment of Type II Odontoid Fractures

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Matthew A. Prevost ◽  
John G. DeVine ◽  
Uzondu F. Agochukwu ◽  
Jacob C. Rumley
Keyword(s):  
Risk Factor ◽  
Case Series ◽  
Odontoid Fracture ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Non Union ◽  
Fracture Displacement ◽  
Increased Risk ◽  
Cervical Orthosis ◽  
History Of

Introduction:Odontoid fractures are one of the most common injuries to the cervical spine. Type II odontoid fracture treatment varies depending on age, co-morbidities, and fracture morphology. Treatment ranges from cervical orthosis to surgical intervention. Currently fractures with high non-union rates are considered for operative management which includes displacement of >6 mm, increasing age (>40-60 years), fracture gap >1 mm, delay in treatment >4 days, posterior re-displacement >2 mm, increased angulation, and history of smoking. While re-displacement of >2 mm has been associated with increased risk of non-union;, to the best of our knowledge, no studies have looked at the risk factors for re-displacement. Case Report:We present two 26-year-old male patients who were found to have minimally displaced type II odontoid fractures initially treated in a cervical collar. These two patients were subsequently found to have displaced their odontoid fracture after having a documented seizure. Conclusion:We suggest that a history of seizures be considered a risk factor for re-displacement of non-displaced type II odontoid fractures. Keywords:Operative indications odontoid case report, Type II odontoid fracture, Displacement, Seizure, Odontoid fracture displacement, Nondisplaced type ? odontoid fracture.

scholarly journals Full-Endoscopic Anterior Odontoid Screw Fixation: A Novel Technique and Technical Report

2020 ◽  
Author(s):  
Vit Kotheeranurak ◽  
Khanathip Jitpakdee ◽  
Phattareeya Pholprajug ◽  
Pritsanai Pruttikul ◽  
Weerasak Singhatanadgige ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Screw Fixation ◽  
Invasive Technique ◽  
Type Ii ◽  
Level Of Evidence ◽  
Odontoid Fractures ◽  
Technical Report ◽  
Effective Option ◽  
Cervical Motion ◽  
Cervical Spine Fractures

Abstract Background: Odontoid fractures are common among cervical spine fractures and are categorized into three types. Unstable type II fractures are among the most challenging to treat, and the best treatment approach has been debated. Anterior odontoid screw fixation, a surgical treatment option, yields a high union rate and helps preserve cervical motion; however, there are risks for approach-related complications. Here, we report a novel minimally invasive technique of full-endoscopic anterior odontoid fixation (FEAOF).Methods: The authors introduce the technique and describe in detail the technical approach of FEAOF for the surgical treatment of type II odontoid fractures.Conclusions: FEAOF is a feasible and effective option for treating type II odontoid fractures. The procedure is less invasive than other techniques and provides clear direct visualization of the involved structures.Level of Evidence: Not applicable

Surgical Treatment of Acute Type II and Rostral Type III Odontoid Fractures Managed by Anterior Screw Fixation

2005 ◽  
Vol 98 (9) ◽  
pp. 895-900 ◽  
Author(s):  
Kostas N. Fountas ◽  
Theofilos G. Machinis ◽  
Eftychia Z. Kapsalaki ◽  
Vassilios G. Dimopoulos ◽  
Carlos H. Feltes ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Screw Fixation ◽  
Acute Type ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Anterior Screw Fixation

NONOPERATIVE MANAGEMENT OF ODONTOID FRACTURES USING A HALOTHORACIC VEST

Neurosurgery ◽  
2007 ◽  
Vol 61 (3) ◽  
pp. 522-530 ◽  
Author(s):  
Patrick Platzer ◽  
Gerhild Thalhammer ◽  
Kambiz Sarahrudi ◽  
Florian Kovar ◽  
Gyoergy Vekszler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Fracture Healing ◽  
Nonoperative Management ◽  
Nonoperative Treatment ◽  
Activity Level ◽  
Long Term Results ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Appropriate Treatment

Abstract OBJECTIVE Despite various reports in the literature, the appropriate treatment of Type II odontoid fractures remains controversial. Although there is an increasing tendency toward surgical treatment of these fractures in recent years, nonoperative treatment strategies are still regarded as a practicable method, particularly in elderly patients with significant comorbidities. One purpose of this study was to determine the functional and radiographic long-term results after rigid immobilization of Type II odontoid fractures using a halothoracic vest. The second aim was to present a case-control series of patients with nonunion of Type II odontoid fractures compared with patients with successful fracture healing to determine specific risk factors for failure of halo immobilization. METHODS We reviewed the clinical and radiographic records of 90 patients with an average age of 69 years at the time of injury who had undergone nonoperative treatment of odontoid fractures using a halothoracic vest between 1988 and 2004. To identify potential risk factors for failure of halo fixation, patients were divided into “cases” and “controls.” Cases were defined as patients with nonfusion after halo immobilization, and controls were patients with successful fracture healing attained with this treatment option. RESULTS Seventy-five patients returned to their preinjury activity level and were satisfied with their treatment. The Smiley-Webster scale showed an overall functional outcome score of 1.64. Successful fracture healing was achieved in 76 patients (84%). In 14 patients, nonunion was diagnosed by standard x-rays and additional computed tomographic scans within 6 to 12 months after trauma. Referring to possible risk factors for failure of halo fixation, nonunion was found significantly more often in older patients and in those with displaced fractures of the odontoid. Secondary loss of reduction and delay of treatment were identified as further risk factors for nonfusion. CONCLUSION With regard to successful fracture healing and functional results of the patients, we had a satisfactory outcome after halo fixation of Type II odontoid fractures. Although a fusion rate of 84% should not be deemed as optimal, nonoperative management of these fractures using a halothoracic vest seems to be an appropriate treatment strategy in patients who are not suitable for surgical treatment.

scholarly journals Who Needs Surgical Stabilization for Pyogenic Spondylodiscitis? Retrospective Analysis of Non-Surgically Treated Patients

2021 ◽  
pp. 219256822110394
Author(s):  
Ronen Blecher ◽  
Sven Frieler ◽  
Bilal Qutteineh ◽  
Clifford A. Pierre ◽  
Emre Yilmaz ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
De Novo ◽  
Vertebral Osteomyelitis ◽  
Case Series ◽  
Spinal Instability ◽  
Radiographic Outcome ◽  
Retrospective Case ◽  
Posterior Element ◽  
Non Surgical Treatment

Study Design: Retrospective case series analysis. Objective: To identify relevant clinical and radiographic markers for patients presenting with infectious spondylo-discitis associated with spinal instability directly related to the infectious process. Methods: We evaluated patients presenting with de-novo intervertebral discitis or vertebral osteomyelitis /discitis (VOD) who initiated non-surgical treatment. Patients who failed conservative treatment and required stabilization surgery within 90 days were defined as “ failed treatment group” (FTG). Patients who experienced an uneventful course served as controls and were labeled as “ nonsurgical group” (NSG). A wide array of baseline clinical and radiographic parameters was retrieved and compared between 2 groups. Results: Overall 35 patients had initiated non-surgical treatment for VOD. 25 patients had an uneventful course (NSG), while 10 patients failed conservative treatment (“FTG”) within 90 days. Factors found to be associated with poorer outcome were intra-venous drug abuse (IVDA) as well as the presence of fever upon initial presentation. Radiographically, involvement of the same-level facets and the extent of caudal and rostral VB involvement in both MRI and CT were found to be significantly associated with poorer clinical and radiographic outcome. Conclusions: We show that clinical factors such as IVDA status and fever as well as the extent of osseous and posterior element involvement may prove to be helpful in favoring surgical treatment early on in the management of spinal infections.

scholarly journals PRP and Articular Cartilage: A Clinical Update

2015 ◽  
Vol 2015 ◽  
pp. 1-19 ◽  
Author(s):  
Antonio Marmotti ◽  
Roberto Rossi ◽  
Filippo Castoldi ◽  
Eliana Roveda ◽  
Gianni Michielon ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Cartilage Defects ◽  
Platelet Concentrates ◽  
Therapeutic Tool ◽  
Complex Scenario

The convincing background of the recent studies, investigating the different potentials of platelet-rich plasma, offers the clinician an appealing alternative for the treatment of cartilage lesions and osteoarthritis. Recent evidences in literature have shown that PRP may be helpful both as an adjuvant for surgical treatment of cartilage defects and as a therapeutic tool by intra-articular injection in patients affected by osteoarthritis. In this review, the authors introduce the trophic and anti-inflammatory properties of PRP and the different products of the available platelet concentrates. Then, in a complex scenario made of a great number of clinical variables, they resume the current literature on the PRP applications in cartilage surgery as well as the use of intra-articular PRP injections for the conservative treatment of cartilage degenerative lesions and osteoarthritis in humans, available as both case series and comparative studies. The result of this review confirms the fascinating biological role of PRP, although many aspects yet remain to be clarified and the use of PRP in a clinical setting has to be considered still exploratory.

Sign in / Sign up

Export Citation Format

Share Document