Department of Orthopedics, Spine Unit, Radboud University Medical Centre, Nijmegen, The Netherlands.
Spine (Phila Pa 1976). 2010 Sep 1;35(19):E965-70. doi: 10.1097/BRS.0b013e3181c9464e.
Prospective single cohort study.
To analyze the incidence, associated injuries, treatment outcomes and associated adverse events of isolated transverse process fractures (TPFs) of the subaxial cervical spine in a high-energy blunt trauma population.
Currently, TPFs of the subaxial cervical spine are considered to be clinically insignificant. However, this hypothesis is based on clinical experience and has never been supported by research previously.
During a 32-month period, routine computed tomography scans of the spine were obtained in high-energy blunt trauma patients. Patients with isolated TPFs of the subaxial cervical spine were prospectively identified. For each enrolled patient, gender, age, mechanism of injury, trauma severity, neurologic deficit, injury levels, affected structures, treatment, radiographic follow-up, functional outcome (Cybex goniometer, neck disability index), and patient satisfaction (10 point visual analog scale) were recorded.
Of 865 enrolled patients, 21 patients (2.4%) had 25 isolated TPFs of the subaxial cervical spine. The seventh vertebra was involved predominantly (76%). The initial treatment regimen was unrestricted movement in all patients. No associated adverse events were observed. A follow-up of 13 to 39 months was available in 14 patients. Follow-up showed a stable and intact subaxial cervical spine in all patients' radiographs, a patient satisfaction of 9.3 (SD 1.48), a Cybex measured range of motion in the sagittal plane of 109 degrees (SD 12.5, 95-129), the frontal plane of 70 (SD 17.8, 37-100) and the transverse plane of 144 (SD 12.5, 116-164), and a mean neck disability index score of 3.93 (SD 8.24).
The incidence of isolated TPFs of the subaxial cervical spine was 2.4%. Unrestricted movement resulted in satisfying functional, anatomic, and neurologic outcomes without associated adverse events. This study confirms that isolated TPFs of the subaxial cervical spine can be considered as clinically insignificant and do not require treatment.
前瞻性单队列研究。
分析高能量钝性创伤人群中发生下颈椎横突骨折（TPF）的发生率、相关损伤、治疗结果和相关不良事件。
目前，下颈椎 TPF 被认为在临床上无意义。然而，这一假设是基于临床经验，以前从未得到过研究的支持。
在 32 个月的时间里，对高能量钝性创伤患者进行常规脊柱 CT 扫描。前瞻性地确定下颈椎横突骨折的患者。对于每个纳入的患者，记录性别、年龄、损伤机制、创伤严重程度、神经缺损、损伤水平、受累结构、治疗、影像学随访、功能结果（Cybex 测角器、颈部残疾指数）和患者满意度（10 分视觉模拟量表）。
在 865 名入组患者中，21 名患者（2.4%）有 25 例下颈椎横突骨折。第七颈椎受累为主（76%）。所有患者的初始治疗方案均为不受限制的活动。未观察到相关不良事件。14 名患者的随访时间为 13 至 39 个月。随访显示所有患者的下颈椎 X 线片均稳定完整，患者满意度为 9.3（SD 1.48），Cybex 测量矢状面活动度为 109 度（SD 12.5，95-129），额状面为 70 度（SD 17.8，37-100）和横断面为 144 度（SD 12.5，116-164），颈部残疾指数评分为 3.93（SD 8.24）。
下颈椎横突骨折的发生率为 2.4%。不受限制的活动导致满意的功能、解剖和神经结果，无相关不良事件。本研究证实，下颈椎横突骨折可视为临床意义不大，无需治疗。
