Upper cervical injuries: Clinical results using a new treatment algorithm

Journal of Craniovertebral Junction and Spine
Andrei F JoaquimAlpesh A Patel

Abstract

Upper cervical injuries (UCI) have a wide range of radiological and clinical presentation due to the unique complex bony, ligamentous and vascular anatomy. We recently proposed a rational approach in an attempt to unify prior classification system and guide treatment. In this paper, we evaluate the clinical results of our algorithm for UCI treatment. A prospective cohort series of patients with UCI was performed. The primary outcome was the AIS. Surgical treatment was proposed based on our protocol: Ligamentous injuries (abnormal misalignment, facet perched or locked, increase atlanto-dens interval) were treated surgically. Bone fractures without ligamentous injuries were treated with a rigid cervical orthosis, with exception of fractures in the dens base with risk factors for non-union. Twenty-three patients treated initially conservatively had some follow-up (mean of 171 days, range from 60 to 436 days). All of them were neurologically intact. None of the patients developed a new neurological deficit. Fifteen patients were initially surgically treated (mean of 140 days of follow-up, ranging from 60 to 270 days). In the surgical group, preoperatively, 11 (73.3%) patients were AIS E, 2 (13.3%) AIS C and 2 (13.3%) AIS D. At the ...Continue Reading

References

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Feb 25, 2014·The Journal of Spinal Cord Medicine·Andrei F JoaquimAlpesh A Patel

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Citations

Jul 1, 2016·Current Reviews in Musculoskeletal Medicine·Loren B MeadAlexander R Vaccaro
Feb 23, 2017·Arquivos de neuro-psiquiatria·Andrei Fernandes JoaquimEberval Gadelha Figueiredo
Jan 31, 2018·The Journal of Craniofacial Surgery·Bulent OzdemirKamil Kayayurt
Jan 1, 2016·The Journal of International Medical Research·Shuai GuoHaopeng Li

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