Postępowanie terapeutyczne w złamaniu zęba obrotnika u osób starszych. Na podstawie opisu przypadku 71-letniego pacjenta

• Authors: Wojciech Ilków , Tomasz Krzeszowiec , Dariusz Łątka

Title variants

EN

Therapeutic management in an elderly patient with odontoid fracture

• Languages of publication: PL

Abstracts

PL

Złamanie zęba obrotnika to najczęściej występujący rodzaj złamania kręgosłupa szyjnego u starszych pacjentów (tj. u osób powyżej 70. roku życia) – możliwa przyczyna inwalidztwa bądź zgonu. W zależności od wyniku badania obrazowego oraz stanu ogólnego chorego ustalane jest dalsze postępowanie terapeutyczne. Autorzy przedstawiają przypadek 71-letniego pacjenta z rozpoznanym w tomografii komputerowej kręgosłupa szyjnego złamaniem zęba obrotnika, leczonego operacyjnie w ramach Oddziału Neurochirurgii Wojewódzkiego Centrum Medycznego w Opolu. Problematyka złamania zęba obrotnika u ludzi starszych została przybliżona w obszernym omówieniu.

EN

Fracture of the odontoid process is the most common type of cervical spine fracture in elderly patients (i.e. population over the age of 70 years), which can lead to disability or death. The therapeutic management depends on imaging findings and patient’s general condition. The authors present a case of a 71-year-old patient diagnosed with odontoid fracture based on cervical spine computed tomography, who received surgical treatment in the Department of Neurosurgery of the Regional Medical Centre in Opole. The problem of odontoid fractures in the elderly has been a subject of a comprehensive discussion.

Keywords

EN

kręgosłup szyjny; leczenie operacyjne; stabilizacja tylna; złamanie zęba obrotnika; śruba dociągowa

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2016
• Volume: 16
• Issue: 4
• Pages: 201–207

Contributors

author

Wojciech Ilków

• Oddział Neurochirurgii, Wojewódzkie Centrum Medyczne w Opolu, Opole, Polska

author

Tomasz Krzeszowiec

• Oddział Neurochirurgii, Wojewódzkie Centrum Medyczne w Opolu, Opole, Polska

author

Dariusz Łątka

• Oddział Neurochirurgii, Wojewódzkie Centrum Medyczne w Opolu, Opole, Polska

References

• Aebi M, Etter C, Coscia M: Fractures of the odontoid process. Treatment with anterior screw fixation. Spine (Phila Pa 1976) 1989; 14: 1065–1070.
• Anderson LD, D’Alonzo RT: Fractures of the odontoid process of the axis. J Bone Joint Surg Am 1974; 56: 1663–1674.
• Andersson S, Rodrigues M, Olerud C: Odontoid fractures: high complication rate associated with anterior screw fixation in the elderly. Eur Spine J 2000; 9: 56–59.
• Apfelbaum RI, Lonser RR, Veres R et al.: Direct anterior screw fixation for recent and remote odontoid fractures. J Neurosurg 2000; 93 (Suppl): 227–236.
• Apuzzo ML, Heiden JS, Weiss MH et al.: Acute fractures of the odontoid process. An analysis of 45 cases. J Neurosurg 1978; 48: 85–91.
• Bednar DA, Parikh J, Hummel J: Management of type II odontoid process fractures in geriatric patients; a prospective study of sequential cohorts with attention to survivorship. J Spinal Disord 1995; 8: 166–169.
• Berlemann U, Schwarzenbach O: Dens fractures in the elderly. Results of anterior screw fixation in 19 elderly patients. Acta Orthop Scand 1997; 68: 319–324.
• Bochenek A, Reicher M: Anatomia człowieka: podręcznik dla studentów i lekarzy. Tom 1: Anatomia ogólna: kości, stawy i więzadła, mięśnie. 11th (7th) ed., Wydawnictwo Lekarskie PZWL, Warszawa 1999: 255–261.
• Cho DC, Sung JK: Analysis of risk factors associated with fusion failure after anterior odontoid screw fixation. Spine (Phila Pa 1976) 2012: 37: 30–34.
• Coyne TJ, Fehlings MG, Wallace MC et al.: C1–C2 posterior cervical fusion: long-term evaluation of results and efficacy. Neurosurgery 1995; 37: 688–793.
• Desai B, Slish J, Allen B: A case of dens fracture: a pictorial review and discussion. Case Rep in Emerg Med 2012; 2012: 864160.
• Fassett DR, Harrop JS, Maltenfort M et al.: Mortality rates in geriatric patients with spinal cord injuries. J Neurosurg Spine 2007; 7: 277–281.
• Frangen TM, Zilkens C, Muhr G et al.: Odontoid fractures in the elderly: dorsal C1/C2 fusion is superior to halo-vest immobilization. J Trauma 2007; 63: 83–89.
• Gallie WE: Fractures and dislocations of the cervical spine. Am J Surg 1939; 46: 495–499.
• Glaser JA, Whitehill R, Stamp WG et al.: Complications associated with the halo-vest. A review of 245 cases. J Neurosurg 1986; 65: 762–769.
• Goel A, Laheri V: Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 1994; 129: 47–53.
• Goel A, Desai KI, Muzumdar DP: Atlantoaxial fixation using plate and screw method: a report of 160 treated patients. Neurosurgery 2002; 51: 1351–1357.
• Greenberg MS: Handbook of Neurosurgery. 7th ed., Thieme Publishers, New York 2010: 964.
• Hanigan WC, Powell FC, Elwood PW et al.: Odontoid fractures in elderly patients. J Neurosurg 1993; 78: 32–35.
• Harms J, Melcher RP: Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine (Phila Pa 1976) 2001; 26: 2467–2471.
• Harris MB, Reichmann WM, Bono CM et al.: Mortality in elderly patients after cervical spine fractures. J Bone Joint Surg Am 2010; 92: 567–574.
• Horn EM, Theodore N, Feiz-Erfan I et al.: Complications of halo fixation in the elderly. J Neurosurg Spine 2006; 5: 46–49.
• Huybregts JGJ, Jacobs WCH, Vleggeert-Lankamp CLAM: The optimal treatment of type II and III odontoid fractures in the elderly: a systematic review. Eur Spine J 2013; 22: 1–13.
• Jaiswal AK, Sharma MS, Behari S et al.: Current management of odontoid fractures. Indian Journal of Neurotrauma 2005; 2: 3–6.
• Jia LS: Basic concepts of diagnosis and treatment of occipital cervical injuries. Chinese Journal of Trauma 2007; 23: 3–5.
• Julien TD, Frankel B, Traynelis VC et al.: Evidence-based analysis of odontoid fracture management. Neurosurg Focus 2000; 8: e1.
• Kuntz C 4th, Mirza SK, Jarell AD et al.: Type II odontoid fractures in the elderly: early failure of nonsurgical treatment. Neurosurg Focus 2000; 8: e7.
• Lennarson PJ, Mostafavi H, Traynelis VC et al.: Management of type II dens fractures: a case-control study. Spine (Phila Pa 1976) 2000; 25: 1234–1237.
• Lieberman IH, Webb JK: Cervical spine injuries in the elderly. J Bone Joint Surg Br 1994; 76: 877–881.
• Magerl F, Seemann PS: Stable posterior fusion of the atlas and axis by transarticular screw fixation. In: Kehr P, Weidner A (eds.): Cervical Spine I: Strasbourg 1985. Springer-Verlag, Wien, New York 1987: 322–327.
• Maiman DJ, Larson SJ: Management of odontoid fractures. Neurosurgery 1982; 11: 471–476.
• Malik SA, Murphy M, Conolly P et al.: Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients. Eur Spine J 2008; 17: 585–591.
• Mayer M, Zenner J, Auffarth A et al.: Efficacy of anterior odontoid screw fixation in the elderly patient: a CT-based biometrical analysis of odontoid fractures. Eur Spine J 2011; 20: 1441–1449.
• Müller EJ, Wick M, Russe O et al.: Management of odontoid fractures in the elderly. Eur Spine J 1999; 8: 360–365.
• Mummaneni PV, Haid RW: Atlantoaxial fixation: overview of all techniques. Neurol India 2005; 53: 408–415.
• Osti M, Philipp H, Meusburger B et al.: Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients. Eur Spine J 2011; 20: 1915–1920.
• Pal D, Sell P, Grevitt P: Type II odontoid fractures in the elderly: an evidence-based narrative review of management. Eur Spine J 2011; 20: 195–204.
• Patel A, Smith HE, Radcliff K et al.: Odontoid fractures with neurologic deficit have higher mortality and morbidity. Clin Orthop Relat Res 2012; 470: 1614–1620.
• Pepin JW, Bourne RB, Hawkins RJ: Odontoid fractures, with special reference to the elderly patient. Clin Orthop Relat Res 1985; (193): 178–183.
• Pointillart V, Orta AL, Freitas J et al.: Odontoid fractures. Review of 150 cases and practical application for treatment. Eur Spine J 1994; 3: 282–285.
• Polin RS, Szabo T, Bogaev CA et al.: Nonoperative management of Types II and III odontoid fractures: the Philadelphia collar versus the halo vest. Neurosurgery 1996; 38: 450–457.
• Pratt H, Davies E, King L: Traumatic injuries of the c1/c2 complex: computed tomographic imaging appearances. Curr Probl Diagn Radiol 2008; 37: 26–38.
• Robinson Y, Robinson AL, Olerud C: Systematic review on surgical and nonsurgical treatment of type II odontoid fractures in the elderly. Biomed Res Int 2014; 2014: 231948.
• Ryan MD, Taylor TKF: Odontoid fractures in the elderly. J Spinal Disord 1993; 6: 397–401. Schweigel JF: Management of the fractured odontoid with halo-thoracic bracing. Spine (Phila Pa 1976) 1987; 12: 838–839.
• Shamji MF, Cook C, Pietrobon R et al.: Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis. Spine J 2009; 9: 31–38.
• Sylwanowicz W (ed.): Anatomia człowieka: podręcznik dla studentów medycyny. 2nd ed., PZWL, Warszawa 1974: 135–136.
• Wang L, Liu C, Zhao QH et al.: Classification and surgical management for the axis fracture complicated with adjacent segment instability. Int J Clin Exp Med 2014; 7: 657–664.

• Document Type: article