Sankar Wudbhav N, Wills Brian P D, Dormans John P, Drummond Denis S
Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Spine (Phila Pa 1976). 2006 Apr 20;31(9):979-84. doi: 10.1097/01.brs.0000214935.70868.1c.
Retrospective analysis of our experience with os odontoideum at the Children's Hospital of Philadelphia.
To review the origin of os odontoideum and provide evidence for two separate etiologies.
The etiology of os odontoideum has been debated in the literature. Most authors support a post-traumatic etiology; however, some evidence exists to support a congenital origin.
We reviewed all 519 abnormal cervical spine radiographs performed from 1991 to 2004 to identify os odontoideum. Medical records and imaging studies were examined to determine: history of trauma, severity of injury, interval from injury to presentation, coexisting syndromes, and associated congenital cervical spine anomalies.
Sixteen of 519 patients (3.1%) had os odontoideum. Only 8 of 16 patients reported previous trauma. Only 3 of these 8 injuries occurred with an interval remote enough to allow remodeling of the dens to an ossicle by the time of presentation. Six of 16 patients had associated congenital anomalies in the cervical spine. Three of 16 had a coexisting genetic syndrome.
Our data supports two separate etiologies for the os odontoideum: post-traumatic and congenital. The data should raise awareness that some children with preexisting syndromes may develop os odontoideum without previous trauma.
对费城儿童医院齿突骨病例的回顾性分析。
回顾齿突骨的起源，并为两种不同病因提供证据。
齿突骨的病因在文献中一直存在争议。大多数作者支持创伤后病因；然而，也有一些证据支持先天性起源。
我们回顾了1991年至2004年间进行的所有519例颈椎异常X线片，以确定齿突骨。检查病历和影像学研究以确定：创伤史、损伤严重程度、受伤至就诊的间隔时间、并存综合征以及相关的先天性颈椎异常。
519例患者中有16例（3.1%）患有齿突骨。16例患者中只有8例报告有既往创伤史。这8例损伤中只有3例发生时的间隔时间足够长，以至于在就诊时齿突已重塑为小骨。16例患者中有6例伴有颈椎先天性异常。16例中有3例并存遗传综合征。
我们的数据支持齿突骨的两种不同病因：创伤后和先天性。这些数据应提高人们的认识，即一些患有既往综合征的儿童可能在没有先前创伤的情况下发生齿突骨。
