Radiological features in type II odontoid fractures in older adults after high- and low-energy trauma
Study designRetrospective study.ObjectivesAlthough type II odontoid fractures mainly occur due to high-energy trauma (HET), the number of odontoid type II fractures after low-energy trauma (LET) in the elderly is on the rise. However, there is a paucity of conclusive evidence on the relationship bet...
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| Main Authors: | , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
October 2023
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| In: |
Global spine journal
Year: 2023, Volume: 13, Issue: 8, Pages: 2471-2478 |
| ISSN: | 2192-5690 |
| DOI: | 10.1177/21925682221088215 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1177/21925682221088215 Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/21925682221088215 
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| Author Notes: | Pavlina Lenga, MD, Mohammed Issa, MD, Lennart Krull, Cand med, Karl Kiening, MD, Andreas W. Unterberg, MD, PhD, Till Schneider, MD, Rod J. Oskouian, MD, Jens R. Chapman, MD, and Basem Ishak, MD |
| Summary: | Study designRetrospective study.ObjectivesAlthough type II odontoid fractures mainly occur due to high-energy trauma (HET), the number of odontoid type II fractures after low-energy trauma (LET) in the elderly is on the rise. However, there is a paucity of conclusive evidence on the relationship between trauma mechanism and cervical spine alignment in the elderly population. Consequently, we examined cervical alignment and osteoporotic and osteoarthritic patterns in elderly individuals (aged ≥65 years) with type II odontoid fractures.MethodsWe retrospectively assessed cervical spine alignment in 76 elderly individuals who experienced type II odontoid fractures after HET (n = 36) and LET (n = 40) between 2005 and 2020. Osteoporotic and osteoarthritic changes on computed tomography and cervical alignment parameters on sagittal plane radiographs were examined.ResultsModerate and severe osteoporosis of the dens-body junction and osteoarthritis of the atlanto-odontoid joint were more prevalent in the LET than the HET group (P<.005). The anterior atlantodental interval (ADI) was significantly smaller in the LET group than in the HET group (.7 [.7] millimeter vs 1.2 [.8] mm; P=.003). An ADI equal 0 mm indicative for anterior fusion of C1/C2 was present in 37.5% of patients of the LET group. The C0-C2 angle, C1-C2 lordosis, and C2-C7 sagittal vertical axis were significantly different (HET vs LET: 33.2 [7.2]° vs 41.6 [11.4]°, P=.005; 28.1 [7.0]° vs 34.0 [8.0]°, P=.002; and 16.1 [11.1] millimeter vs 27.1 [12.4] mm, P=.008; respectively).ConclusionSignificantly higher rates of osteoporotic and degenerative changes were observed after LET. Furthermore, previous cervical malalignment represents a risk factor for type II odontoid fractures after LET. |
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| Item Description: | Online veröffentlicht: March 28, 2022 Gesehen am 01.06.2022 |
| Physical Description: | Online Resource |
| ISSN: | 2192-5690 |
| DOI: | 10.1177/21925682221088215 |