RT Journal Article
SR Electronic
T1 Upper Cervical Spine Injuries: Profile and Management of 120 Cases
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8321
DO 10.14444/8321
A1 Carneiro-Filho, Geraldo de Sá
A1 de Macêdo, Lívio Pereira
A1 Andrade, Lidemarcks Irineu
A1 Alves-Sá, Brenno Franklynn
A1 Sousa, Luan Amaral Magalhães
A1 Medeiros Quirino, Saul Cavalcanti de
A1 Chaves, Juliano Rodrigues
A1 Bezerra-Júnior, Deoclides Lima
A1 Almeida, Nivaldo S.
A1 Azevedo-Filho, Hildo Rocha Cirne
YR 2022
UL https://www.ijssurgery.com/content/early/2022/07/01/8321.abstract
AB Objectives To identify the profile and management of patients with upper cervical spine injury.Methods Retrospective cohort study of patients with upper cervical spine injuries managed at Hospital da Restauração between 2014 and 2020.Results It presents the profile of 145 injuries recorded by location and classification among the 120 patients, and the management performed. Men are more affected than women, almost half of the patients (42.5%) were aged 16 to 29 years. Neurological deficit was present in 18 cases (15%). Twenty cases presented injury involving the level C1. Most injuries (109 [90.8%]) occurred at the C2 level, the most frequent of which were as follows: isolated type II odontoid fracture (29.2%), miscellaneous fracture of C2 (20%), and isolated hangman’s fracture (13.3%). The most used management in type II odontoid fracture was C1-C2 posterior arthrodesis (17/42) followed by odontoid osteosynthesis (12/42). Regarding isolated hangman’s fracture, conservative management was performed in 37.5% (6/16), and the technical approach most performed was anterior C2-C3 discectomy and interbody fusion (5/16).Conclusions Upper cervical spine injury has a higher prevalence in young men and is most often caused by traffic accidents. The main level affected is C2, and type II odontoid fracture is the most frequent subtype. C1 injury is related to conservative treatment, while C2 or combined C1-C2 injury is related to surgical approach. The management of these injuries is mainly performed with surgical treatment, with C1-C2 posterior arthrodesis and anterior odontoid osteosynthesis representing most of the approaches.