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Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases

Spine surgeons often confuse C2 pedicle fractures (PFs) with pars interarticularis fractures. In addition, little information is available about the characteristics and treatment strategies for C2 PFs. We sought to investigate the characteristics of C2 PFs and to propose an appropriate treatment str...

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Autores principales: Park, Jong-Beom, Kim, Sung-Kyu, Seo, Hyoung-Yeon, Ko, Jong-Hyun, Hong, Tae-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432505/
https://www.ncbi.nlm.nih.gov/pubmed/34501435
http://dx.doi.org/10.3390/jcm10173987
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author Park, Jong-Beom
Kim, Sung-Kyu
Seo, Hyoung-Yeon
Ko, Jong-Hyun
Hong, Tae-Min
author_facet Park, Jong-Beom
Kim, Sung-Kyu
Seo, Hyoung-Yeon
Ko, Jong-Hyun
Hong, Tae-Min
author_sort Park, Jong-Beom
collection PubMed
description Spine surgeons often confuse C2 pedicle fractures (PFs) with pars interarticularis fractures. In addition, little information is available about the characteristics and treatment strategies for C2 PFs. We sought to investigate the characteristics of C2 PFs and to propose an appropriate treatment strategy. A total of forty-nine patients with C2 PFs were included in this study. We divided these patients into unilateral and bilateral C2 PF groups. The incidence rates and characteristics of other associated C2 and C2-3 injuries, and other cervical injuries, were evaluated. In addition, treatment methods and outcomes were analyzed. Twenty-two patients had unilateral C2 PFs and twenty-seven patients had bilateral C2 PFs. Among the cases of unilateral C2 PFs, all patients had one or more other C2 fractures, and twenty patients (90.9%) had one or two C2 body fractures. Meanwhile, among the cases of bilateral C2 PF, all patients had two or more other C2 fractures and one or two C2 body fractures. In unilateral C2 PFs, three patients with C2-3 anterior slip or adjacent cervical spine (C1-3) injury underwent surgery and nineteen patients (86.4%) were treated with conservative methods. In bilateral C2 PFs, three patients with C2-3 anterior slip or SCI at C2-3 underwent surgery and twenty-four patients (88.9%) were treated with conservative methods. Our results showed that C2 PFs do not occur alone and are always accompanied by other associated C2 injuries. C2 PFs should, generally, be thought of as a more complex fracture type than hangman’s fracture or dens fracture. Despite the complex fracture characteristics, most C2 PFs can be managed with conservative treatment. However, surgical treatments should be considered if the C2 PFs are accompanied by the C2-3 anterior slip and adjacent cervical spine injury.
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spelling pubmed-84325052021-09-11 Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases Park, Jong-Beom Kim, Sung-Kyu Seo, Hyoung-Yeon Ko, Jong-Hyun Hong, Tae-Min J Clin Med Article Spine surgeons often confuse C2 pedicle fractures (PFs) with pars interarticularis fractures. In addition, little information is available about the characteristics and treatment strategies for C2 PFs. We sought to investigate the characteristics of C2 PFs and to propose an appropriate treatment strategy. A total of forty-nine patients with C2 PFs were included in this study. We divided these patients into unilateral and bilateral C2 PF groups. The incidence rates and characteristics of other associated C2 and C2-3 injuries, and other cervical injuries, were evaluated. In addition, treatment methods and outcomes were analyzed. Twenty-two patients had unilateral C2 PFs and twenty-seven patients had bilateral C2 PFs. Among the cases of unilateral C2 PFs, all patients had one or more other C2 fractures, and twenty patients (90.9%) had one or two C2 body fractures. Meanwhile, among the cases of bilateral C2 PF, all patients had two or more other C2 fractures and one or two C2 body fractures. In unilateral C2 PFs, three patients with C2-3 anterior slip or adjacent cervical spine (C1-3) injury underwent surgery and nineteen patients (86.4%) were treated with conservative methods. In bilateral C2 PFs, three patients with C2-3 anterior slip or SCI at C2-3 underwent surgery and twenty-four patients (88.9%) were treated with conservative methods. Our results showed that C2 PFs do not occur alone and are always accompanied by other associated C2 injuries. C2 PFs should, generally, be thought of as a more complex fracture type than hangman’s fracture or dens fracture. Despite the complex fracture characteristics, most C2 PFs can be managed with conservative treatment. However, surgical treatments should be considered if the C2 PFs are accompanied by the C2-3 anterior slip and adjacent cervical spine injury. MDPI 2021-09-03 /pmc/articles/PMC8432505/ /pubmed/34501435 http://dx.doi.org/10.3390/jcm10173987 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Jong-Beom
Kim, Sung-Kyu
Seo, Hyoung-Yeon
Ko, Jong-Hyun
Hong, Tae-Min
Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases
title Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases
title_full Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases
title_fullStr Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases
title_full_unstemmed Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases
title_short Proposal of Treatment Strategy for Pedicle Fractures of the C2: An Analysis of 49 Cases
title_sort proposal of treatment strategy for pedicle fractures of the c2: an analysis of 49 cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432505/
https://www.ncbi.nlm.nih.gov/pubmed/34501435
http://dx.doi.org/10.3390/jcm10173987
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