![]() Younger patients are more susceptible to high-energy trauma-related injuries, while elderly sustain bone density-related injuries. This finding is not uncommon among spinal fractures. The most common C2 fracture-the odontoid fracture-has a biphasic age distribution with peaks both at 20–30 and at 70–80 years of age. Knowledge of these proportions facilitates future epidemiological studies of C2 fractures.įractures of the second cervical vertebra (C2) are the most common cervical spinal injury among elderly. This study presents reliable subset proportions of C2 fractures in a prospectively collected regional cohort. 40% of C2 fractures were treated surgically. There was an increasing incidence of odontoid fractures types 2 and 3 from 2002 to 2014. In the geriatric subgroup 89% of all C2 fractures were odontoid, of which 71% were type 2 and 29% type 3. Odontoid fractures were found in 183 patients, of which 2 were type 1, 127 type 2, and 54 type 3, while 26 of C2 fractures were Hangman's fractures and 24 were atypical C2 fractures. 233 patients (female 51%, age 72 ± 19 years) were treated for a C2 fracture. C2 fractures were classified into odontoid fractures types 1, 2, and 3, Hangman's fractures types 1, 2, and 3, and atypical C2 fractures. A dataset of all patients treated between 20 for C2 fractures was extracted from the regional hospital information system. This study was designed to identify the proportions of the second cervical vertebra (C2) fracture subtypes and to present age and gender specific incidences of subgroups. doi:10.The currently available data on the distribution of C2 fracture subtypes is sparse. AOSpine-Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles. Occipitocervical Dissociation-Incidence, Evaluation, and Treatment. Atlanto-Occipital Dislocation-Part 2: The Clinical Use of (Occipital) Condyle-C1 Interval, Comparison with Other Diagnostic Methods, and the Manifestation, Management, and Outcome of Atlanto-Occipital Dislocation in Children. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Reassessment of the Craniocervical Junction: Normal Values on CT. Rojas C, Bertozzi J, Martinez C, Whitlow J. Rheumatoid arthritis: CT/MRI will show atlantooccipital instability due to pannus destabilisation of joints and ligaments, and x-ray will show erosions Odontoid fracture: type 2 will cause posterior dens displacement and will disrupt Powers ratioĪtlanto-axial subluxation: atlantoaxial rotatory fixation will cause C1 lateral mass asymmetry relative to the densĭown syndrome: atlanto-occipital instability due to laxity of the alar ligament Jefferson fracture: anterior and posterior C1 ring fracture, possible lateral masses displacement Powers ratio >1 (insensitive to a vertical distraction injury or posterior dissociation)įor pediatric patients, the condyle-C1 interval (CCI) has been shown to provide the highest diagnostic accuracy 4.Ĭondyle-C1 interval (CCI) >4 mm in children The key to the diagnosis, in addition to identifying gross disruption of the normal alignment of the atlanto-occipital joint, hinges on using a number of lines on the lateral horizontal shoot-through cervical spine film 1:īasion-dens interval (BDI) >10 mm in adults 3īasion-axial interval (BAI) >12 mm in adults The AO Spine classification of upper cervical injuries is another classification system split into location-specific patterns and then further subdivided according to injury type and presence of neurological signs and/or modifying factors. The Traynelis classification describes injuries according to the displacement of the occipital condyles relative to the atlas. The tectorial membrane and alar ligaments provide most of the stability to the atlanto-occipital joint, and injury to these ligaments results in instability due to low inherent osseous stability 3.
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