Acute axis fractures: a review of 229 cases

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✓ Eighteen percent of acute cervical spine fractures involve the C-2 vertebra. The odontoid Type II fracture is the most common axis fracture and it is also the most difficult to treat. The degree of odontoid dislocation has been identified as the single most important fracture feature that helps separate those patients who have a high likelihood of healing with nonoperative therapy from those who are likely to fail nonoperative therapy and should be offered early surgical stabilization. The difference is statistically significant (p < 0.001, x2 = 30.20).

The present series includes 229 patients with acute axis fractures. Follow-up data were available in 92% of these patients, for a median duration of 4 years 9 months. Treatment guidelines and results are offered for each subtype of axis fracture based on this experience.

Article Information

Current address for Dr. Hadley: Division of Neurological Surgery, David Grant Medical Center, Travis Air Force Base, California.

Address reprint requests to: Volker K. H. Sonntag, M.D., c/o Editorial Office, Barrow Neurological Institute, 350 West Thomas Road, Phoenix, Arizona 85013.

© AANS, except where prohibited by US copyright law.

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Figures

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    Correlation of dens dislocation, direction of dislocation, and the incidence of nonunion for odontoid Type II fractures in 87 cases.

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    Correlation of dens dislocation, patient age, and the incidence of nonunion for odontoid Type II fractures in 87 cases.

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