Nwachuku Enyinna, Njoku-Austin Confidence, Patel Kevin P, Anthony Austin W, Mittal Aditya, Hamilton David Kojo, Kanter Adam, Gerszten Peter C, Okonkwo David
Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Surg Neurol Int. 2021 Oct 19;12:524. doi: 10.25259/SNI_748_2021. eCollection 2021.
Occipital condyle fractures (OCFs) have been reported in up to 4-16% of individuals suffering cervical spine trauma. The current management of OCF fractures relies on a rigid cervical collar for 6 weeks or longer. Here, we calculated the rate of acute and delayed surgical intervention (occipitocervical fusion) for patients with isolated OCF who were managed with a cervical collar over a 10-year period at a single institution.
This was a retrospective analysis performed on all patients admitted to a Level 1 Trauma Center between 2008 and 2018 who suffered traumatic isolated OCF managed with an external rigid cervical orthosis. Radiographic imaging was reviewed by several board-certified neuroradiologists. Demographic and clinical data were collected including need for occipitocervical fusion within 12 months after trauma.
The incidence of isolated OCF was 4% (60/1536) for those patients admitted with cervical spine fractures. They averaged 49 years of age, and 58% were male falls accounted for the mechanism of injury in 47% of patients. Classification of OCF was most commonly classified in 47% as type I Anderson and Montesano fractures. Of the 60 patients who suffered isolated OCF that was managed with external cervical orthosis, 0% required occipitocervical fusion within 12 months posttrauma. About 90% were discharged, while the remaining 10% sustained traumatic brain/orthopedic injury that limited an accurate neurological assessment.
Here, we documented a 4% incidence of isolated OCF in our cervical trauma population, a rate which is comparable to that found in the literature year. Most notably, we documented a 0% incidence for requiring delayed occipital-cervical fusions.
据报道，在颈椎创伤患者中，枕髁骨折（OCF）的发生率高达4%-16%。目前OCF骨折的治疗方法是使用刚性颈托固定6周或更长时间。在此，我们计算了在一家机构中，10年间采用颈托治疗的孤立性OCF患者的急性和延迟手术干预（枕颈融合）率。
这是一项对2008年至2018年期间入住一级创伤中心、因创伤性孤立性OCF而采用外部刚性颈椎矫形器治疗的所有患者进行的回顾性分析。数位获得委员会认证的神经放射科医生对影像学检查结果进行了评估。收集了人口统计学和临床数据，包括创伤后12个月内是否需要进行枕颈融合。
颈椎骨折患者中孤立性OCF的发生率为4%（60/1536）。他们的平均年龄为49岁，58%为男性，47%的患者损伤机制为跌倒。OCF最常见的分类是47%为I型安德森和蒙特萨诺骨折。在60例采用外部颈椎矫形器治疗的孤立性OCF患者中，0%在创伤后12个月内需要进行枕颈融合。约90%的患者出院，其余10%患有创伤性脑/骨科损伤，这限制了准确的神经学评估。
在此，我们记录了颈椎创伤患者中孤立性OCF的发生率为4%，这一发生率与文献报道相当。最值得注意的是，我们记录了延迟枕颈融合的发生率为0%。
