[Accident-induced pseudarthroses of the dens axis. Etiology, follow-up and therapy].
In a retrospective analysis the significance of internal fixation of unstable and symptomatic non-union of the odontoid was evaluated. In all but one cases a type II fracture of the odontoid was the underlying cause for the pseudarthrosis. The time interval between trauma and definitive diagnosis varied between 6 months and 30 years. All patients asked for medical advice because of acute neck pain; in three cases additional neurological deficits were notified. In all but one case the pseudarthrosis was classified as unstable on flexion-/extension views. The occurrence of neurological deficits showed a positive correlation with the amount of dislocation of the pseudarthrotic odontoid. Nine out of 10 patients underwent internal stabilisation of the non-union. Reoperation because of persistent instability/failure of stabilisation had to be performed in two cases (22.2%). At follow-up all 9 patients were pain-free. The neurological deficits in two patients had improved significantly. According to our experience internal stabilisation in unstable non-union of the odontoid is recommended to achieve significant reduction of the pain level. Also improvement of the neurological deficits can be expected depending on the duration of the symptoms.
Müller
E J
EJ
Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhruniversität, Bochum.
Wick
M
M
Russe
O
O
Muhr
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
Unfallbedingte Pseudarthrosen des Dens axis. Atiologie, Verlauf und Therapie.