Bronson Wesley H, Protopsaltis Themistocles
Bull Hosp Jt Dis (2013). 2019 Mar;77(1):4-10.
Fractures of the odontoid represent as much as 20% of cervical spine fractures in adults, and they are the most common spine fracture in patients over 80 years of age. Despite their prevalence, the management of these fractures remains highly controversial. In particular, there is much debate concerning the management of type II fractures, or fractures occurring about the waist of the odontoid. We will review the epidemiology, evaluation, management-both operative and non-operative-and outcomes of adults with type II odontoid fractures. We will particularly focus on debates concerning hard collar versus halo, anterior versus posterior surgery, the management of odontoid nonunions, as well as questions about risks and benefits of surgery in the very elderly.
齿突骨折占成人颈椎骨折的20%，是80岁以上患者最常见的脊柱骨折。尽管其发病率较高，但这些骨折的治疗仍存在很大争议。特别是，关于II型骨折（即齿突腰部骨折）的治疗存在诸多争论。我们将回顾II型齿突骨折成人患者的流行病学、评估、手术及非手术治疗方法和治疗结果。我们将特别关注关于硬颈托与头环、前路与后路手术、齿突不愈合的治疗，以及高龄患者手术风险和益处的相关争论。
