Odontoid fractures with neurologic deficit have higher mortality and morbidity.

Publication/Presentation Date

6-1-2012

Abstract

BACKGROUND: Type II odontoid fractures are reportedly increasing in incidence and occur primarily in the elderly. Neurologic deficits (ND) at presentation add to the morbidity of these fractures; however, reports are limited as a result of small case series. It is unclear what specific complications are associated with ND and whether these result in increased incidence of mortality.

QUESTIONS/PURPOSES: We established the incidence of ND with Type II odontoid fractures and determined if ND are associated with increased inpatient mortality and morbidity during hospitalization.

METHODS: Twenty patients with acute Type II odontoid fracture and ND were identified from our institutional database. Baseline presenting characteristics and hospital course data were collected. The cohort was compared with a previously published cohort of 188 patients without ND by age, mechanism of injury, displacement, associated spinal injuries, comorbidities, treatment, mortality, and complications. Patients were only followed during acute-care hospitalization (mean, 11.9 days; range, 0-41 days).

RESULTS: The incidence of ND among all Type II odontoid fractures was 9.6%. Ten of 20 patients with Type II odontoid fractures and ND died during hospitalization, and patients with complete cord injuries were 9.33 (95% confidence interval, 1.19-73.0) times more likely to die. Patients with ND experienced more complications and more respiratory complications than those without ND.

CONCLUSIONS: ND after Type II odontoid fractures is a rare event associated with a high risk of early and rapid clinical decline.

LEVEL OF EVIDENCE: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Volume

470

Issue

6

First Page

1614

Last Page

1620

ISSN

1528-1132

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

21830169

Department(s)

Administration and Leadership

Document Type

Article

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