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可预测齿状突骨折治疗方式的放射学测量参数分析:临床研究

Analysis of radiological measurement parameters that can predict the type of treatment to be applied in odontoid fractures: Clinical research.

作者信息

Ogden Mustafa, Erdogan Ahmet Melih, Karagedik Mustafa Ilker, Baser Selcuk, Bulut Ibrahim Umud, Sevimoglu Ozge, Yuksel Ulas, Bakar Bulent

机构信息

Department of Neurosurgery, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Department of Radiology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

出版信息

J Craniovertebr Junction Spine. 2023 Jul-Sep;14(3):245-252. doi: 10.4103/jcvjs.jcvjs_20_23. Epub 2023 Sep 18.

Abstract

INTRODUCTION

Although various conservative and surgical treatment methods have been proposed, treatment options for patients with odontoid fractures remain controversial. This study was conducted to determine some demographic and radiological measurement parameters that can predict treatment options in patients with odontoid fractures.

MATERIALS AND METHODS

The patients were separated into the surgery (-) group ( = 9) and the surgery (+) group ( = 10). Patient data were recorded of age, gender, type of odontoid fracture, morphological measurement results obtained from computed tomography images, treatment regimens, duration of stay in the hospital, and mortality rate. In the operating room, a halo-vest corset or Philadelphia-type cervical collar was applied to the surgery (-) patients after the reduction of the fracture under fluoroscopy. Anterior odontoid lag screw fixation was performed on surgery (+) patients.

RESULTS

The amount of displacement of the fractured odontoid, the distance between the C1 vertebra and the odontoid process, the angle between the posterior wall of the odontoid process and the posterior wall of the clivus, the slip angle, and the anterior to posterior width of the spinal canal were not different between the groups. No difference was determined between the groups in respect of the amount of lateral displacement of the odontoid process in the spinal canal in the axial plane and the angle of the fractured odontoid process with the C2 vertebral body.

CONCLUSION

This preliminary study showed that the demographic data and radiological measurement parameters analyzed in the present study could not be used as predictive markers either in decision-making for treatment modality or mortality risk.

摘要

引言

尽管已经提出了各种保守和手术治疗方法,但齿状突骨折患者的治疗选择仍存在争议。本研究旨在确定一些人口统计学和放射学测量参数,以预测齿状突骨折患者的治疗选择。

材料与方法

将患者分为手术(-)组(n = 9)和手术(+)组(n = 10)。记录患者的年龄、性别、齿状突骨折类型、从计算机断层扫描图像获得的形态学测量结果、治疗方案、住院时间和死亡率。在手术室中,对手术(-)组患者在透视下骨折复位后应用头环背心式颈托或费城型颈托。对手术(+)组患者进行前路齿状突拉力螺钉固定。

结果

两组之间骨折齿状突的移位量、C1椎体与齿状突之间的距离、齿状突后壁与斜坡后壁之间的角度、滑脱角以及椎管的前后宽度没有差异。两组在轴向平面上齿状突在椎管内的侧方移位量以及骨折齿状突与C2椎体的角度方面没有差异。

结论

这项初步研究表明,本研究中分析的人口统计学数据和放射学测量参数在治疗方式决策或死亡风险方面均不能用作预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2985/10583795/b6160e09008e/JCVJS-14-245-g001.jpg

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