From the Department of Orthopaedics, Oregon Health and Science University, Portland, OR.
Spine (Phila Pa 1976). 2013 Apr 20;38(9):752-6. doi: 10.1097/BRS.0b013e31827ab62a.
Nationwide epidemiological cohort study.
To characterize the incidence of second cervical vertebral (C2) fractures by age and geographical region among the elderly Medicare population and to elucidate if the rate changed in the years 2005 to 2008.
Recent publications hypothesized that the rate of cervical vertebral fractures may be increasing. To date, there are no published nationwide reports describing the incidence and demographics of these injuries in the elderly US population.
Incidence of C2 fracture in the years 2005 to 2008 was determined by querying PearlDiver Technologies, Inc. (Warsaw, IN), a commercially available database, using International Classification of Diseases code 805.02. Rates were calculated using the PearlDiver reported person-counts as the numerator and the Center for Medicare and Medicare Services midyear population file as the denominator, and reported per 10,000 person-years (10,000 p-y). The age and geographical distributions of fractures were examined. Variability in rates was analyzed using the mean, standard deviation, 95% confidence intervals, χ tests, and Pearson correlation coefficients.
Although the elderly population increased by 6% between 2005 and 2008, the annual incidence of C2 fracture rose by 21%, from 1.58 to 1.91 per 10,000 p-y, trending upward in a straight-line function (r = 0.999, P = 0.0006). The incidence of fracture varied between age groups; however, an increase was observed in all age groups. Persons aged 65 to 74 years (the youngest age group) experienced the lowest incidence (0.63 in 2005 to 0.71 in 2008), and the rate of increase was the smallest among the age groups examined (13%). Persons aged 85 and older demonstrated the highest incidence (4.36-5.67) and the greatest increase (30%).
From 2005 to 2008, the overall incidence of C2 fracture rose at a rate that was 3.5 times faster than the elderly population growth.
全国性的流行病学队列研究。
描述老年医疗保险人群中第二颈椎（C2）骨折的发病率，并按年龄和地理区域进行分析，同时阐明 2005 年至 2008 年期间该发病率是否发生了变化。
最近的研究报告表明，颈椎骨折的发生率可能在上升。迄今为止，还没有关于美国老年人群中这些损伤的发生率和人口统计学数据的全国性报告。
使用 PearlDiver Technologies， Inc.（印第安纳州华沙）的商业可用数据库，通过查询国际疾病分类第 805.02 编码，确定 2005 年至 2008 年 C2 骨折的发生率。使用 PearlDiver 报告的人数作为分子，医疗保险和医疗补助服务中心年中人口文件作为分母，计算发病率，并报告每 10000 人年（10000 人年）的发病率。检查骨折的年龄和地理分布。使用平均值、标准差、95%置信区间、χ 检验和 Pearson 相关系数分析率的变异性。
尽管 2005 年至 2008 年间老年人口增长了 6%，但 C2 骨折的年发病率上升了 21%，从每 10000 人年的 1.58 上升至 1.91，呈直线上升趋势（r = 0.999，P = 0.0006）。骨折发病率在不同年龄组之间存在差异；然而，所有年龄组都观察到了发病率的增加。年龄在 65 至 74 岁之间（年龄最小的组）的患者发病率最低（2005 年为 0.63，2008 年为 0.71），且在所研究的年龄组中增长率最小（13%）。年龄在 85 岁及以上的患者发病率最高（4.36-5.67），增长率最大（30%）。
从 2005 年至 2008 年，C2 骨折的总体发病率上升速度是老年人口增长率的 3.5 倍。
