Traumatic fractures of the craniovertebral junction. Management of 23 cases.
Twenty-three consecutive cases of traumatic C1-C2 fractures treated at the Department of Neurosurgery, University of Milano, are reported. Of these there were 13 cases of odontoid fractures, 6 hangman fractures, 2 anterior inferior corner fractures, 2 atlas-axis combination fractures and 2 Jefferson fractures. Almost all the patients were young people involved in motor vehicle accidents. Nineteen patients were treated with external immobilization (halo vest, Minerva) for 3-6 months while 4 odontoid fractures underwent early surgical posterior stabilization. At follow-up, 20 patients had a good fusion while 3, aged over 75 years, died due to cardiopulmonary or septic complications. The appropriate management of this type of lesion is still a matter of discussion. In our opinion the Halo device allows good stabilization after correct fracture reduction.
Zavanone
M
M
Istituto di Neurochirurgia, Università degli Studi di Milano, Italy.
Guerra
P
P
Rampini
P
P
Crotti
F
F
Vaccari
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000293:injuries; D016103:Spinal Fractures / Q000601:surgery* / Q000628:therapy; D014947:Wounds and Injuries / Q000601:surgery*