枢椎骨折：小儿、成人及老年损伤的综述
Fractures of the axis: a review of pediatric, adult, and geriatric injuries.
作者信息
Gornet Megan E, Kelly Michael P
机构信息
Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD, 21205, USA.
Department of Orthopedic Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8233, Saint Louis, MO, 63110, USA.
出版信息
Curr Rev Musculoskelet Med. 2016 Dec;9(4):505-512. doi: 10.1007/s12178-016-9368-1.
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery. Regardless of treatment, longer-term mortality rates are high in this patient population, which should be discussed with the patient and family at the time of injury. Pediatric patients may suffer fractures of the axis, though differentiation of normal and pathologic findings is necessary and more difficult with the skeletally immature spine.
第二颈椎（C2，枢椎）骨折在成人脊柱手术中很常见。发生在年轻成年患者中的那些骨折通常与高能量机制创伤有关，导致“绞刑者骨折”。这些骨折的治疗通常通过非手术方法取得成功，不过对于那些移位较大且C2-C3椎间盘受损的骨折可能需要手术。老年患者更有可能发生齿突骨折。支持这些骨折手术治疗的证据在不断发展，因为手术可能有降低死亡率的益处。无论采用何种治疗方法，该患者群体的长期死亡率都很高，受伤时应与患者及其家属讨论这一点。儿科患者可能会发生枢椎骨折，不过对于骨骼未成熟的脊柱，区分正常和病理表现是必要的且更困难。
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