Department of Orthopaedic Surgery/Spine Services, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Seattle, WA 98104, USA.
Eur Spine J. 2011 Nov;20(11):1928-39. doi: 10.1007/s00586-011-1903-6. Epub 2011 Jul 28.
Type II odontoid fractures are one among the most common cervical spine fractures in the elders. We reviewed a consecutive series of patients, aged 65 years and older, presenting to our institution with type II odontoid fractures. Our analysis focused on the radiographic outcome, union rate and the development of cervical spine postural deformity.
PATIENTS/METHODS: Indications for surgical treatment (OP) included displaced or unstable injuries. Stable, non-displaced injuries or patients with significant co-morbidities were treated nonoperatively (non-op).
Ninety patients (50 f, 40 m) with an average age of 83 years (65-101) were identified. 31 (34.4%) patients were received OP and 57 (63.3%) were received non-op treatments. The hospital length of stay was significantly longer after OP (mean 10 days vs. 6 days non-op) treatment (p = 0.007). At follow-up, higher union rates were noted in the OP (76.2%) than in the non-op group (58.3%).
We observed a characteristic cervical spine deformity in geriatric patients with type II odontoid fractures, and have termed this the "Geier-deformity". Clinical findings of the deformity include sagittal imbalance and kyphosis of the lower cervical spine.
II 型齿状突骨折是老年人中最常见的颈椎骨折之一。我们回顾了一组连续的患者，年龄在 65 岁及以上，因 II 型齿状突骨折到我院就诊。我们的分析重点是影像学结果、愈合率和颈椎姿势畸形的发展。
患者/方法：手术治疗（OP）的指征包括移位或不稳定的损伤。稳定、无移位的损伤或有明显合并症的患者接受非手术治疗（非 OP）。
共确定了 90 例（50 例女性，40 例男性）患者，平均年龄 83 岁（65-101）。31 例（34.4%）患者接受 OP 治疗，57 例（63.3%）患者接受非 OP 治疗。OP 治疗后住院时间明显延长（平均 10 天 vs. 非 OP 治疗 6 天）（p = 0.007）。随访时，OP 组的愈合率（76.2%）明显高于非 OP 组（58.3%）。
我们观察到老年 II 型齿状突骨折患者存在一种特征性的颈椎畸形，并将其命名为“Geier 畸形”。该畸形的临床特征包括矢状位失衡和下颈椎后凸。
