结合地图和轴骨折的管理:系统性审查
Neil V Mohile1, Alexander S Kuczmarski1, Arya Minaie1
1Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami Health System, 1611 NW 12th Ave, Miami, FL 33136, United States.
North American Spine Society journal
|July 13, 2023
概括
结合的地盘轴骨折很少见,但具有较高的神经缺陷的风险. 治疗取决于骨折的稳定性,而手术干预通常对于不稳定的伤害是必要的,尽管技术各不相同.
科学领域:
- 整形外科 整形外科 整形外科
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
背景情况:
- 结合的地盘轴骨折很少见,与单独的损伤相比,与神经学缺陷的更高率有关.
- 亚特拉斯和轴脊椎的复杂解剖学导致各种各样的骨折模式,需要专门的外科治疗.
研究的目的:
- 系统地审查有关急性结合的天空轴骨折的文献.
- 分析患者的人口统计,损伤特征,管理策略和结果.
主要方法:
- 使用PubMed和EMBASE数据库进行了系统的文献搜索.
- 研究根据PRISMA指南进行了审查,重点关注与人口统计,陈述,管理和并发症相关的数据.
主要成果:
- 分析了包括230名患者的22篇文章 (1977-2022年).
- 17%的患者出现了神经系统缺陷.
- 常见的地盘骨折包括后弓骨折 (32%) 和联合弓骨折 (26%). 第二种类型的牙骨折在轴部最常见 (66%).
- 55%的患者接受了手术管理,C1-C2后脊髓融合是最常见的手术 (35%的手术病例).
结论:
- 管理以骨折类型和横横带完整性为指导.
- 稳定的骨折可以非手术治疗;不稳定的骨折 (例如,大于5毫米的atlantodental间隔) 通常需要手术干预.
- 对于这些复杂骨折的最佳手术技术,没有共识.
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