@article{ref1,
title="Odontoid Fractures With Neurologic Deficit Have Higher Mortality and Morbidity",
journal="Clinical orthopaedics and related research",
year="2011",
author="Patel, Amar and Smith, Harvey E. and Radcliff, Kris and Yadlapalli, Navin and Vaccaro, Alexander R.",
volume="470",
number="6",
pages="1614-1620",
abstract="BACKGROUND: Type II odontoid fractures are reportedly increasing in incidence and occur primarily in the elderly. Neurologic deficits (ND) at presentation add to the morbidity of these fractures; however, reports are limited as a result of small case series. It is unclear what specific complications are associated with ND and whether these result in increased incidence of mortality. QUESTIONS/PURPOSES: We established the incidence of ND with Type II odontoid fractures and determined if ND are associated with increased inpatient mortality and morbidity during hospitalization. METHODS: Twenty patients with acute Type II odontoid fracture and ND were identified from our institutional database. Baseline presenting characteristics and hospital course data were collected. The cohort was compared with a previously published cohort of 188 patients without ND by age, mechanism of injury, displacement, associated spinal injuries, comorbidities, treatment, mortality, and complications. Patients were only followed during acute-care hospitalization (mean, 11.9 days; range, 0-41 days). RESULTS: The incidence of ND among all Type II odontoid fractures was 9.6%. Ten of 20 patients with Type II odontoid fractures and ND died during hospitalization, and patients with complete cord injuries were 9.33 (95% confidence interval, 1.19-73.0) times more likely to die. Patients with ND experienced more complications and more respiratory complications than those without ND. CONCLUSIONS: ND after Type II odontoid fractures is a rare event associated with a high risk of early and rapid clinical decline. LEVEL OF EVIDENCE: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.<p /><p>Language: en</p>",
language="en",
issn="0009-921X",
doi="10.1007/s11999-011-1994-8",
url="http://dx.doi.org/10.1007/s11999-011-1994-8"
}