Tarazi Nadim, Munigangaiah Sudarshan, Devitt Aiden T, Mccabe John P
Department of Trauma and Orthopaedics, Galway University Hospital, Galway, Ireland.
J Craniovertebr Junction Spine. 2017 Oct-Dec;8(4):328-331. doi: 10.4103/jcvjs.JCVJS_98_17.
Occipitocervical disease is common in the elderly population, and is on the rise due to an increasingly aging population.
We retrospectively reviewed all patients who underwent occipitocervical fusion in our institution over a 20 year period (1996-2016) at a tertiary spinal referral centre. Patients were divided in 2 groups. Group A included all patient who underwent OCF in the first decade between 1996 and 2005. Group B was all patients who underwent OCF in the second decade between 2006 and 2016.
A total of 23 patients underwent occipitocervical fusion between 1996 until 2016 at our institution. Instability secondary to Rheumatoid arthritis was the leading factor in group A, responsible for 43 percent of cases. In group B, trauma was the leading burden accounting for 44 percent of the cases. In contrast to Group A however, only 19 % of OCFs occurred secondary to RA in group B. Our fusion rate was 96 percent with a survival rate of 67 percent.
We noticed a clear epidemiological drift in the cervical spine pathologies requiring OCF during the first and second decade of study period with an increase in prevalence of pathological fractures secondary to metastatic disease. In addition, a drop in rheumatoid cervical disease requiring OCF has been noted.
枕颈疾病在老年人群中很常见，并且由于人口老龄化加剧而呈上升趋势。
我们回顾性分析了在一家三级脊柱转诊中心20年期间（1996 - 2016年）在我们机构接受枕颈融合术的所有患者。患者分为两组。A组包括1996年至2005年第一个十年间接受枕颈融合术的所有患者。B组是2006年至2016年第二个十年间接受枕颈融合术的所有患者。
1996年至2016年期间，共有23例患者在我们机构接受了枕颈融合术。类风湿性关节炎继发的不稳定是A组的主要因素，占病例的43%。在B组中，创伤是主要负担，占病例的44%。然而，与A组相比，B组中仅19%的枕颈融合术是由类风湿性关节炎继发的。我们的融合率为96%，生存率为67%。
我们注意到在研究期的第一个和第二个十年中，需要枕颈融合术的颈椎病理情况存在明显的流行病学变化，转移性疾病继发的病理性骨折患病率增加。此外，已注意到需要枕颈融合术的类风湿性颈椎疾病有所下降。
