Mortality related to and functional outcomes of upper cervical spine fractures in the elderly |
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| Institution: | 1. Shoulder and Elbow Unit. Instituto Traumatológico, San Martin #771, PC 8340220, Santiago, Chile;2. Department of Orthopedics and Trauma. Universidad de Chile, Independencia #1027, PC 8380453, Santiago, Chile;3. Shoulder and Elbow Unit. Pontifical Catholic University of Chile, Diagonal Paraguay #362, PC 8330077, Santiago, Chile;4. Department of Orthopedics and Trauma, Pontifical Catholic University of Chile, Diagonal Paraguay #362, PC 8330077, Santiago, Chile;1. Department of Orthopedics and Traumatology, Sakarya University, Sakarya Training and Research Hospital, Sakarya, Turkey;2. Department of Orthopedics and Traumatology, Health Sciences University, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey;3. Department of Orthopedics and Traumatology, Ordu University, Ordu Training and Research Hospital, Ordu, Turkey;4. Department of Histology and Embryology, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey;5. Department of Biochemistry, Bolu Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey;6. Department of Orthopedics and Traumatology, Bolu Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey;1. Department of Orthopaedic Surgery, Tohoku Rosai Hospital, 4-3-21 Dainohara, Aoba-ku, Sendai, 981-8563, Japan;2. Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan;3. Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Tatsutayashiki, Sanezawa, Izumi-ku, Sendai, 981-3217, Japan;4. Department of Orthopaedic Surgery, Tohoku Central Hospital, 3-2-5 Wago-machi, Yamagata, 990-8510, Japan;5. Department of Orthopaedic Surgery, Osaki Citizen Hospital, 3-8-1 Furukawa-Honami, Osaki, Miyagi, 989-6183, Japan;6. Department of Orthopaedic Surgery, Sendai Orthopaedic Hospital, 3-5-3 Izai, Wakabayashi-ku, Sendai, 984-0038, Japan;7. Department of Orthopaedic Surgery, Sendai Nishitaga Hospital, 2-11-11 Kagitorihoncho, Taihaku-ku, Sendai, 982-8555, Japan |
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| Abstract: | BackgroundAlthough the mortality related to hip fracture and osteoporotic vertebral fracture have been reported, few studies have examined the mortality related to atlas and/or axis fractures. The aim of this study was to assess the association between mortality and atlas and/or axis fractures retrospectively and to elucidate the efficacy of surgical treatment.MethodsA total of 33 elderly patients who were treated for atlas and/or axis fractures at our institution between January 2012 and December 2018 were included in this study. These patients were divided into two groups: surgical treatment and conservative treatment. Fracture types, comorbidities, neurological status, treatment types, and walking ability at follow-up were reviewed. Mortality was assessed using medical records or via phone interviews.ResultsThe mean age at injury was 79.9 ± 8.0 years, and the mean follow-up period was 2.3 years. The overall mortality rates at 1 and 5 years were 21.4% and 48.4%, respectively. During the observation period, 12 (36%) patients died. Twenty-two patients were treated conservatively (14 were treated with a cervical collar, 8 were treated with a halo vest). Surgical procedures included occipital-cervical fixation, osteosynthesis of C2 fractures, C1–2 fixation, and C1–4 fixation using a posterior approach. Surgical treatment correlated with better survival rates. There was no significant difference between the two groups in terms of ambulatory ability and functional recovery.ConclusionUpper cervical spine fractures appear to have a worse prognosis compared to hip and osteoporotic vertebral fractures. This study indicates the efficacy of surgical treatment for upper cervical spine fractures in the elderly for improving survival prognosis. |
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