Faure Aymeric, Prost Solène, Mansouri Nacer, Farah Kaissar, Blondel Benjamin, Fuentes Stéphane
Department of Orthopedics, University Hospital Center of la Timone, Aix-Marseille University, Marseille, France.
Department of Orthopedics, University Hospital Center of la Timone, Aix-Marseille University, Marseille, France.
World Neurosurg. 2018 Aug;116:e1087-e1091. doi: 10.1016/j.wneu.2018.05.172. Epub 2018 Jun 1.
Odontoid fracture is the most common lesion of the cervical spine in persons age >70 years. Management of these fractures has become a public health issue. In this study, we evaluated bone fusion, early complications, and mortality in a cohort of patients age >75 years who underwent surgical management of odontoid fracture using the Harms technique.
This study is a retrospective analysis of 57 patients treated surgically between 2002 and 2016 in a single spine surgery institution. Age at diagnosis, comorbidities, and American Society of Anesthesiologists (ASA) score were analyzed. At a 6-month follow-up, bone healing was evaluated with computed tomography scans.
The mean patient age was 85.5 ± 6.6 years, and 53% of the patients had an ASA score ≥3. According to the Anderson classification, 70% of the patients had a type 2 odontoid fracture. The average duration of follow-up was 15.7 months. Ten patients were lost to follow-up. The rate of early complications was 19%, with no mechanical complications reported. At a 6-month follow-up, a solid bony union was seen in all patients. The 1-year mortality was 14%.
Surgical management of odontoid fractures in elderly patients using the Harms technique is associated with an excellent rate of bone healing with acceptable rates of early complications and mortality.
齿状突骨折是70岁以上人群中最常见的颈椎损伤。这些骨折的治疗已成为一个公共卫生问题。在本研究中，我们评估了一组年龄大于75岁、采用哈姆斯技术接受齿状突骨折手术治疗的患者的骨融合情况、早期并发症及死亡率。
本研究是对2002年至2016年在一家脊柱外科机构接受手术治疗的57例患者进行的回顾性分析。分析了诊断时的年龄、合并症及美国麻醉医师协会（ASA）评分。在6个月随访时，通过计算机断层扫描评估骨愈合情况。
患者平均年龄为85.5±6.6岁，53%的患者ASA评分≥3。根据安德森分类法，70%的患者为2型齿状突骨折。平均随访时间为15.7个月。10例患者失访。早期并发症发生率为19%，未报告机械性并发症。在6个月随访时，所有患者均可见牢固的骨愈合。1年死亡率为14%。
采用哈姆斯技术对老年患者的齿状突骨折进行手术治疗，骨愈合率高，早期并发症和死亡率可接受。
