| アブストラクト | PURPOSE: To examine the clinical features and post-treatment complications in patients with isolated C2 odontoid fractures. METHODS: We extracted data for all patients who were admitted with C2 odontoid fractures from the Japanese Diagnosis Procedure Combination database between July 2010 and March 2017. We then compared the post-treatment complications during hospitalization according to treatment types: conservative treatment (with or without use of halo-vest) and surgery (anterior or posterior spinal fixation). RESULTS: A total of 3167 patients (1533 men, 1634 women; mean age, 70 years) with isolated C2 odontoid fractures were identified, including 1124 patients (35%) aged >/= 80 years. Among the total patients, 2476 (78%) received conservative treatment (with halo-vest, 728; without halo-vest, 1748). The remaining 691 patients (22%) underwent surgery (anterior surgery, 129; posterior surgery, 556; combined surgery, 6). There were no differences between the conservative treatment and surgery groups in baseline characteristics and preexisting comorbid conditions except for age (71 vs. 69 years, p = 0.042). In-hospital death occurred in 136 patients (4.3%). There was no significant difference in in-hospital mortality between the two groups (overall, conservative treatment 4.6% vs. surgery 3.0%, p = 0.066; age >/= 80 years, conservative treatment 7.2% vs. surgery 5.4%, p = 0.34). Use of halo-vest was not associated with increased mortality (with halo-vest 3.7% vs. without halo-vest 5.0%, p = 0.15). CONCLUSION: The great majority of isolated odontoid fractures occurred in elderly patients. Conservative treatment and surgery had similarly low in-hospital mortality. Use of halo-vest was not associated with an increase in mortality. |
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| 投稿日 | 2021/5/8 |
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| 投稿者 | Honda, Akira; Michihata, Nobuaki; Iizuka, Yoichi; Mieda, Tokue; Takasawa, Eiji; Ishiwata, Sho; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Chikuda, Hirotaka |
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| ジャーナル名 | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society |
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| 組織名 | Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine,;3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan. m1820046@gunma-u.ac.jp.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.;m1820046@gunma-u.ac.jp.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.;3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, 45-5-1 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33959795/ |
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