Titre
One-year follow-up for type II odontoid process fractures in octogenarians: Is there a place for surgical management?
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Borsotti, F.
Auteure/Auteur
Starnoni, D.
Auteure/Auteur
Ecker, T.
Auteure/Auteur
Coll, J.B.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2229-5097
Statut éditorial
Publié
Date de publication
2020
Volume
11
Première page
285
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
Type II odontoid fractures are becoming one of the most common injuries among elderly patients and are associated with increased morbidity rates. Here, we compared the safety/efficacy of conservative versus surgical treatment for type II C2 fractures and, in particular, evaluated the complications, hospital lengths of stay, and mortality rates for patients over 80 years of age.
We retrospectively reviewed the records of 63 nonsurgically versus 18 surgically treated C2 fractures in patients over 80 years of age (2003-2018). Cervical computed tomography images, X-rays, and magnetic resonance images were reviewed by both a neurosurgeon and a neuroradiologist. The following patient data were included in the analysis; Glasgow Coma Scale score, injury severity score, the abbreviated injury scale scores, their comorbidities (e.g., utilizing the Charlson comorbidity index), their primary outcomes, and mortality rates (e.g., at 6 weeks and 1 year after treatment).
Eighty-one patients were included in the study; 63 were treated conservatively and 18 underwent surgical management of type II C2 fractures. Patients averaged 87.0 ± 5.0 years of age, and their combined mortality rates were 13.6% at 6 weeks and 25.9% at 1 year. Notably, at 1 year, the mortality rates were not statistically different between the two groups: 18 (30.0%) patients from the conservatively treated group versus 3 (16.7%) patients from the surgically managed patients died indicating (e.g., using the Kaplan-Meier analysis) no survival advantage for either treatment strategy.
Surgical versus conservative management of type II odontoid fractures were associated with comparable high mortality rates at 1 year.
We retrospectively reviewed the records of 63 nonsurgically versus 18 surgically treated C2 fractures in patients over 80 years of age (2003-2018). Cervical computed tomography images, X-rays, and magnetic resonance images were reviewed by both a neurosurgeon and a neuroradiologist. The following patient data were included in the analysis; Glasgow Coma Scale score, injury severity score, the abbreviated injury scale scores, their comorbidities (e.g., utilizing the Charlson comorbidity index), their primary outcomes, and mortality rates (e.g., at 6 weeks and 1 year after treatment).
Eighty-one patients were included in the study; 63 were treated conservatively and 18 underwent surgical management of type II C2 fractures. Patients averaged 87.0 ± 5.0 years of age, and their combined mortality rates were 13.6% at 6 weeks and 25.9% at 1 year. Notably, at 1 year, the mortality rates were not statistically different between the two groups: 18 (30.0%) patients from the conservatively treated group versus 3 (16.7%) patients from the surgically managed patients died indicating (e.g., using the Kaplan-Meier analysis) no survival advantage for either treatment strategy.
Surgical versus conservative management of type II odontoid fractures were associated with comparable high mortality rates at 1 year.
PID Serval
serval:BIB_B7B351628FB1
PMID
Open Access
Oui
Date de création
2020-09-23T10:45:47.648Z
Date de création dans IRIS
2025-05-21T04:23:04Z
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Nom
33033647_BIB_B7B351628FB1.pdf
Version du manuscrit
published
Taille
442.96 KB
Format
Adobe PDF
PID Serval
serval:BIB_B7B351628FB1.P001
URN
urn:nbn:ch:serval-BIB_B7B351628FB18
Somme de contrôle
(MD5):bb72b461f74e25ba3f61a9e9bcb3e1d0