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KMID : 0388720210280030071
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Journal of Korean Society of Spine Surgery
2021 Volume.28 No. 3 p.71 ~ p.79
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Morphological Features and Clinical Results of C2 Vertebral Body Fractures
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Son Eun-Seok
Choi Hyeong-Uk
Lee In-Gyu
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Abstract
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Study Design: Retrospective.
Objectives: To classify and analyze the morphological patterns of axis body fractures and report the clinical results.
Summary of Literature Review: The classification of axis body fractures and treatment results have been rarely reported and are a matter of debate.
Materials and Methods: Among 107 patients diagnosed with an axis fracture from 2005 to 2019, 53 patients with fracture involvement of the axis body were included. After the exclusion of 9 patients with a history of cervical spine surgery or who were lost to follow-up, 44 consecutive patients were enrolled in this retrospective study. Patients were classified into 5 groups (coronal, sagittal, transverse, avulsion, and complex) according to the main fracture line. Demographic data, injury mechanism, discoligamentous injury, combined injury, neurological symptoms, and clinical treatment results were analyzed.
Results: Patients’ average age was 61.7 years (range, 25?81 years). Twenty-four patients were male and 20 were female. The average follow-up period was 14.2 months (range, 7?33 months). The coronal, sagittal, transverse, avulsion, and complex groups contained 5, 5, 8, 7, and 19 patients, respectively. Six patients were injured by slip-down accidents, 12 patients by falls from a height, and 26 patients by traffic accidents. Eighteen patients presented with a discoligamentous injury. Twenty-five patients showed a combined injury in the form of a fracture to other cervical vertebrae and bones. Thirteen patients presented neurological symptoms. Sixteen patients were treated with a neck collar and 28 patients were treated with a halo-vest. Two patients eventually required surgical fusion because union was not achieved with conservative management. In the final follow-up, all neurological symptoms were resolved; however, 4 patients still complained of a mild tingling sensation in the upper extremity. In the halo-vest group, pin site infection occurred in 3 patients, but it was controlled after antibiotic administration.
Conclusions: Axis body fractures accounted for almost 50% of axis fractures. They can be classified into 5 groups (coronal, sagittal, transverse, avulsion, and complex) according to the morphological pattern. Non-operative management can be a reasonable treatment option with good clinical results and bone union.
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KEYWORD
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Cervical trauma, Axis, Body, Fracture, Classification
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