TY  - JOUR
PY  - 2011//
TI  - Odontoid Fractures With Neurologic Deficit Have Higher Mortality and Morbidity
JO  - Clinical orthopaedics and related research
A1  - Patel, Amar
A1  - Smith, Harvey E.
A1  - Radcliff, Kris
A1  - Yadlapalli, Navin
A1  - Vaccaro, Alexander R.
SP  - 1614
EP  - 1620
VL  - 470
IS  - 6
N2  - 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>
LA  - en
SN  - 0009-921X
UR  - http://dx.doi.org/10.1007/s11999-011-1994-8
ID  - ref1
ER  -