Dergiler / Acta Orthopaedica et Traumatologica Turcica / 2019 / Cilt: 53 - Sayı: 6

Clinical and radiological outcomes of conservative treatment for unilateral sagittal split fractures of C1 lateral mass

Sayfa
402–407
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

However, conservative treatment may be sufficient for a USSF of the C1 LM with TAL intact

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Objective: The aim of this study was to assess the effect of transverse atlantal ligament (TAL) integrity on clinical and radiological outcomes in patients with unilateral sagittal split fracture (USSF) of the C1 lateral mass (LM).
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Temel Bulgular & Veri:Methods: Twenty-six consecutive patients (16 men and 10 women; mean age: 52 years (range: 32e69)) with C1 LM USSF were included in this study.
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Sonuç & Katkı:However, conservative treatment may be sufficient for a USSF of the C1 LM with TAL intact
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: The aim of this study was to assess the effect of transverse atlantal ligament (TAL) integrity on clinical and radiological outcomes in patients with unilateral sagittal split fracture (USSF) of the C1 lateral mass (LM). Methods: Twenty-six consecutive patients (16 men and 10 women; mean age: 52 years (range: 32e69)) with C1 LM USSF were included in this study. Sixteen were TAL injury group (nine of type I injuries and seven of type II injuries according to Dickman's classification) and ten were TAL intact group. All cases were conservatively treated with a rigid brace for TAL intact or by halo-vest stabilization for TAL injury for three months. The mean follow-up was 16 months (range, 12e47 months). The results were compared with radiological assessment of fracture healing, LM displacement and Neck visual analog scale. Results: At the last follow-up, for TAL intact group, total LM displacement (LMD), unilateral LMD of fracture side, atlanto-dental interval, basion-dental interval, clivus canal angle, and atlanto-occipital joint axis angle were maintained compared to initial presentation. However, for TAL injury group, all radiological parameters were worsened. The worsening of radiological parameters was more severe in type I injury than type II injury except for total LMD and unilateral LMD. Neck visual analog scale significantly decreased and patient's satisfaction was higher in TAL intact group compared to TAL injury group. Conclusion: Conservative treatment for USSF of C1 LM with TAL injury failed to achieve healing of the fracture, which resulted in lateral displacement of C1 LM. This caused coronal and sagittal malalignment of occipitocervical junction, resulting in unsatisfactory clinical outcomes. Our results suggest that early surgical stabilization should be considered in USSF of C1 LM with TAL injury, especially type I injury. However, conservative treatment may be sufficient for a USSF of the C1 LM with TAL intact

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Bu Makaleye Atıf Yap

KİM, W. J., PARK, J., PARK, H., SONG, K., MİN, W. (2019). Clinical and radiological outcomes of conservative treatment for unilateral sagittal split fractures of C1 lateral mass. Acta Orthopaedica et Traumatologica Turcica, Cilt: 53 - Sayı: 6, 402–407. https://ajindex.com/articles/150438

Kaynakça (14)

  1. Felbaum DR, Stewart JJ, Suskin ZD, Gill WH, Sandhu FA. Unilateral C1 sagittal split fractures: an unusual entity revisited. World Neurosurg. 2018;109: 263e270
  2. Pumberger M, Druschel C, Disch AC. Transposition of the vertebral artery after a unilateral C1 lateral mass fracture A case report and review of the literature. Clin J Sport Med. 2015;25:e59ee61
  3. Bransford R, Falicov A, Nguyen Q, Chapman J. Unilateral C-1 lateral mass sagittal split fracture: an unusual Jefferson fracture variant. J Neurosurg Spine. 2009;10:466e473
  4. Bransford R, Chapman JR, Bellabarba C. Primary internal fixation of unilateral C1 lateral mass sagittal split fractures. A series of 3 cases. J Spinal Disord Tech. 2011;24:157e163
  5. Woods RO, Inceoglu S, Akpolat YT, Cheng WK, Jabo B, Danisa O. C1 lateral mass displacement and transverse atlantal ligament failure in Jefferson's fracture: a biomechanical study of the ”Rule of Spence”. Neurosurgery. 2018;82:226e231
  6. Shatsky J, Bellabarba C, Nguyen Q, Bransford RJ. A retrospective review of fixation of C1 ring fractures e does the transverse atlantal ligament (TAL) really matter? Spine J. 2016;6:372e379
  7. Kaiser DR, Ciarpaglini R, Maestretti G. An uncommon C1 fracture with longitudinal split of the transverse ligament. Eur Spine J. 2012;21:S471eS474
  8. Bevevino AJ, Tee J, Ailon T, Dvorak M. Are Jefferson fractures with a transverse ligament avulsion potentially unstable? Clin Spine Surg. 2016;29:39e41
  9. Koller H, Resch H, Tauber M, et al. A biomechanical rationale for C1-ring osteosynthesis as treatment for displaced Jefferson burst fractures with incompetency of the transverse atlantal ligament. Eur Spine J. 2010;19: 1288e1298
  10. Smoker WRK, Khanna G. Imaging the craniocervical junction. Childs Nerv Syst. 2008;24:1123e1145
  11. Harris Jr JH, Carson GC, Wagner LK, Kerr N. Radiologic diagnosis of traumatic occipitovertebral dissociation: 1. Normal occipitovertebral relationships on lateral radiographs of supine subjects. Am J Radiol. 1994;162:881e886
  12. Harris Jr JH, Carson GC, Wagner LK, Kerr N. Radiologic diagnosis of traumatic occipitovertebral dissociation: 2. Comparison of three methods of detecting occipitovertebral relationships on lateral radiographs of supine subjects. Am J Radiol. 1994;62:887e892
  13. Gehweiler GA, Duff DE, Martinez S, Miller MD, Clark WM. Fractures of the atlas vertebra. Skelet Radiol. 1976;1:97e102
  14. Landells CD, Van Peteghem PK. Fractures of the atlas: classification, treatment and mo