De Bonis Pasquale, Trapella Giorgio, Mongardi Lorenzo, Olei Simone, Musio Antonio, Iaccarino Corrado, Lofrese Giorgio, Molinari Filippo, Dugoni Demo, Ghadirpour Reza, Servadei Franco, Cavallo Michele Alessandro
Neurosurgery, Sant'Anna University Hospital, Ferrara, Italy.
Department of Morphology, Surgery and Experimental Medicine, Ferrara University, Ferrara, Italy.
Acta Neurochir Suppl. 2019;125:329-333. doi: 10.1007/978-3-319-62515-7_48.
While several papers on mortality and the fusion rate in elderly patients treated surgically or non-surgically for odontoid fractures exist, little information is available on quality of life after treatment. The aim of treatment in these patients should not be fracture healing alone but also quality of life improvement.A literature search using PubMed identified seven papers including information on functional evaluation of 402 patients.Patients treated with anterior screw fixation had a good functional outcome in 92.6% of cases. This percentage seemed to decrease in octogenarians. Less information was available for patients treated with posterior approaches; it would seem that up to a half of such patients experienced pain and limitations in activities of daily living after surgery. Patients treated with a halo device had a functional outcome that was worse (or at least no better) than that of patients treated with surgery, with absence of limitations in activities of daily living in 77.3% of patients. Patients treated with a collar had a good functional outcome in the majority of cases, with absence of limitations in activities of daily living in 89% of patients.More studies are needed for evaluation of functional outcome, especially in patients treated with a collar, a halo device or a posterior approach.
虽然有几篇关于老年齿状突骨折手术或非手术治疗患者死亡率和融合率的论文，但关于治疗后生活质量的信息却很少。这些患者的治疗目标不应仅仅是骨折愈合，还应包括生活质量的改善。使用PubMed进行的文献检索发现了7篇论文，其中包含402例患者功能评估的信息。接受前路螺钉固定治疗的患者中，92.6%的病例功能结局良好。在八旬老人中，这一比例似乎有所下降。关于后路手术治疗患者的信息较少；似乎多达一半的此类患者术后出现疼痛和日常生活活动受限。接受头环装置治疗的患者功能结局比接受手术治疗的患者更差（或至少没有更好），77.3%的患者日常生活活动不受限。大多数接受颈托治疗的患者功能结局良好，89%的患者日常生活活动不受限。需要更多研究来评估功能结局，尤其是接受颈托、头环装置或后路手术治疗的患者。
