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Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model

BACKGROUND: Along with the growing geriatric population, the number of odontoid fractures is steadily increasing. However, the effectiveness of immobilizing geriatric odontoid fractures using a cervical collar has been questioned. The aim of the present study is to analyze the physiological and path...

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Autores principales: Jung, Matthias K., von Ehrlich-Treuenstätt, Gregor V. R., Jung, Andreas L., Keil, Holger, Grützner, Paul A., Schneider, Niko R. E., Kreinest, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629171/
https://www.ncbi.nlm.nih.gov/pubmed/34843595
http://dx.doi.org/10.1371/journal.pone.0260414
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author Jung, Matthias K.
von Ehrlich-Treuenstätt, Gregor V. R.
Jung, Andreas L.
Keil, Holger
Grützner, Paul A.
Schneider, Niko R. E.
Kreinest, Michael
author_facet Jung, Matthias K.
von Ehrlich-Treuenstätt, Gregor V. R.
Jung, Andreas L.
Keil, Holger
Grützner, Paul A.
Schneider, Niko R. E.
Kreinest, Michael
author_sort Jung, Matthias K.
collection PubMed
description BACKGROUND: Along with the growing geriatric population, the number of odontoid fractures is steadily increasing. However, the effectiveness of immobilizing geriatric odontoid fractures using a cervical collar has been questioned. The aim of the present study is to analyze the physiological and pathological motion in odontoid fractures and to assess limitation of motion in the cervical spine when applying a cervical collar. METHODS: Motion analysis was performed with wireless motion tracker on unfixed geriatric human cadavers. First, a new geriatric type II odontoid fracture model was developed. In this model, the type II odontoid fracture is operated via a transoral approach. The physiological and pathological flexion and lateral bending of the cervical spine resulting from this procedure was measured. The resulting motion after external stabilization using a cervical collar was analyzed. RESULTS: The new geriatric type II odontoid fracture model was successfully established using seven unfixed human cadavers. The pathological flexion of the cervical spine was significantly increased compared to the physiological flexion (p = 0.027). Furthermore, the flexion was significantly reduced when a cervical collar was applied. In case of flexion the mean remaining motion was significantly reduced (p = 0.0017) from 41° to 14°. For lateral bending the mean remaining motion was significantly reduced (p = 0.0137) from 48° to 18°. CONCLUSIONS: In case of type II odontoid fracture, flexion and lateral bending of the cervical spine are increased due to spinal instability. Thus, if an odontoid fracture is suspected in geriatric patients, the application of a cervical collar should always be considered since external stabilization can significantly reduce flexion and lateral bending.
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spelling pubmed-86291712021-11-30 Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model Jung, Matthias K. von Ehrlich-Treuenstätt, Gregor V. R. Jung, Andreas L. Keil, Holger Grützner, Paul A. Schneider, Niko R. E. Kreinest, Michael PLoS One Research Article BACKGROUND: Along with the growing geriatric population, the number of odontoid fractures is steadily increasing. However, the effectiveness of immobilizing geriatric odontoid fractures using a cervical collar has been questioned. The aim of the present study is to analyze the physiological and pathological motion in odontoid fractures and to assess limitation of motion in the cervical spine when applying a cervical collar. METHODS: Motion analysis was performed with wireless motion tracker on unfixed geriatric human cadavers. First, a new geriatric type II odontoid fracture model was developed. In this model, the type II odontoid fracture is operated via a transoral approach. The physiological and pathological flexion and lateral bending of the cervical spine resulting from this procedure was measured. The resulting motion after external stabilization using a cervical collar was analyzed. RESULTS: The new geriatric type II odontoid fracture model was successfully established using seven unfixed human cadavers. The pathological flexion of the cervical spine was significantly increased compared to the physiological flexion (p = 0.027). Furthermore, the flexion was significantly reduced when a cervical collar was applied. In case of flexion the mean remaining motion was significantly reduced (p = 0.0017) from 41° to 14°. For lateral bending the mean remaining motion was significantly reduced (p = 0.0137) from 48° to 18°. CONCLUSIONS: In case of type II odontoid fracture, flexion and lateral bending of the cervical spine are increased due to spinal instability. Thus, if an odontoid fracture is suspected in geriatric patients, the application of a cervical collar should always be considered since external stabilization can significantly reduce flexion and lateral bending. Public Library of Science 2021-11-29 /pmc/articles/PMC8629171/ /pubmed/34843595 http://dx.doi.org/10.1371/journal.pone.0260414 Text en © 2021 Jung et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jung, Matthias K.
von Ehrlich-Treuenstätt, Gregor V. R.
Jung, Andreas L.
Keil, Holger
Grützner, Paul A.
Schneider, Niko R. E.
Kreinest, Michael
Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model
title Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model
title_full Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model
title_fullStr Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model
title_full_unstemmed Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model
title_short Evaluation of external stabilization of type II odontoid fractures in geriatric patients—An experimental study on a newly developed cadaveric trauma model
title_sort evaluation of external stabilization of type ii odontoid fractures in geriatric patients—an experimental study on a newly developed cadaveric trauma model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629171/
https://www.ncbi.nlm.nih.gov/pubmed/34843595
http://dx.doi.org/10.1371/journal.pone.0260414
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