title: The significance of rotation in fracture-separation of the articular pillar of a lower cervical vertebra. A clinical and cadaveric study.
abstract: We report 13 fracture-separations of an articular pillar at the lower cervical spine in 12 patients. There were 9 men and 3 women with a mean age at injury of 32 years, with involvement of C4, C5 and C6 vertebrae. Neurological symptoms were present in 9 patients, 2 were classified as ASIA A and 7 as ASIA D. The average magnitude of rotation of the articular pillar was 24 degrees (10 degrees-36 degrees). 4 patients with neurologic deficit and a rotated articular pillar of more than 25 degrees were operated on, while 8 patients, 3 of which had a rotation of more than 25 degrees, had closed treatment. Patients were followed from 8 months to 15 years (mean 9 years). Patients who had closed treatment and/or with a rotated fractured articular pillar of more than 25 degrees had less satisfactory results. This observation was affirmed by cadaveric studies which showed that rotation of more than 25 degrees is an additional factor of instability in a fractured articular pillar.
authors.affiliation: Department of Orthopaedic Surgery, University of Athens Medical School, KAT Accident Hospital, Greece.
authors.forename: D S
authors.initials: DS
authors.lastname: Korres
authors.forename: P
authors.initials: P
authors.lastname: Nikiforidis
authors.forename: N
authors.initials: N
authors.lastname: Papandreou
authors.forename: A B
authors.initials: AB
authors.lastname: Zoubos
authors.forename: G C
authors.initials: GC
authors.lastname: Babis
authors.forename: I
authors.initials: I
authors.lastname: Tsarouchas
authors.forename: V
authors.initials: V
authors.lastname: Lycomitros
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012399:Rotation; D016103:Spinal Fractures / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome