C1-C2 fractures in asymptomatic elderly patients with minor head trauma: evaluation with a dedicated head CT protocol

Squarza, Silvia; Uggetti, Carla; Politi, Marco Angelo; Pescatori, Lorenzo; Bisogno, Raffaele; Campi, A.; Reganati, Paolo; Cariati, Maurizio

doi:10.1590/0100-3984.2017.0154

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Patients aged 65 years and older were found to be more frequently affected by cervical spine injuries. The literature describes low-energy injuries, low-risk mechanisms, decreases in total mobility, and degenerative changes as causative factors [ 32 , 33 ]. Additionally, a blood pressure ≤ 90 mmHg was found to be a significant predictor for the spine and cervical spine injuries.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Häske

Lefering

Stock

et al. 2020

Eur J Trauma Emerg Surg

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Purpose This study aimed to identify the prevalence and predictors of spinal injuries that are suitable for immobilization. Methods Retrospective cohort study drawing from the multi-center database of the TraumaRegister DGU®, spinal injury patients ≥ 16 years of age who scored ≥ 3 on the Abbreviated Injury Scale (AIS) between 2009 and 2016 were enrolled. Results The mean age of the 145,833 patients enrolled was 52.7 ± 21.1 years. The hospital mortality rate was 13.9%, and the mean injury severity score (ISS) was 21.8 ± 11.8. Seventy percent of patients had no spine injury, 25.9% scored 2–3 on the AIS, and 4.1% scored 4–6 on the AIS. Among patients with isolated traumatic brain injury (TBI), 26.8% had spinal injuries with an AIS score of 4–6. Among patients with multi-system trauma and TBI, 44.7% had spinal injuries that scored 4–6 on the AIS. Regression analysis predicted a serious spine injury (SI; AIS 3–6) with a prevalence of 10.6% and cervical spine injury (CSI; AIS 3–6) with a prevalence of 5.1%. Blunt trauma was a predictor for SI and CSI (OR 4.066 and OR 3.640, respectively; both p < 0.001) and fall > 3 m for SI (OR 2.243; p < 0.001) but not CSI (OR 0.636; p < 0.001). Pre-hospital shock was predictive for SI and CSI (OR 1.87 and OR 2.342, respectively; both p < 0.001), and diminished or absent motor response was also predictive for SI (OR 3.171) and CSI (OR 7.462; both p < 0.001). Patients over 65 years of age were more frequently affected by CSI. Conclusions In addition to the clinical symptoms of pain, we identify ‘4S’ [spill (fall) > 3 m, seniority (age > 65 years), seriously injured, skull/traumatic brain injury] as an indication for increased attention for CSIs or indication for spinal motion restriction.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Häske

Lefering

Stock

et al. 2020

Eur J Trauma Emerg Surg

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“…According to Squarza et al, the CT is the most cost-effective method in the case of Hangman's fractures [4]. If a CT scan had been performed and dislocation of the lateral mass was diagnosed, but the study had failed to prove a rupture of the TAL, magnetic resonance imaging should be performed [5].…”

Section: Discussionmentioning

confidence: 99%

Clinical Behavior of General Practitioners for Patients who Underwent an Operative or Conservative Treatment for a Craniocervical Fracture

Kalnev

Uchikov

Kehayov

2022

Open Access Maced J Med Sci

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Craniocervical fractures are socially important pathology. They represent one-third of the fractures in the cervical region. It is typical that elderly patients suffer from low-energy traumas such as falls, while younger patients suffer from high-energy traumas such as motor vehicle accidents, sport falls and etc. Craniocervical fractures are associated with an increased risk of craniocervical instability or neurological deficit. Primary therapeutic options depend on the type of fracture. Predictors of nonunions are the displacement of fractures, patients’ age, and comorbidities. The observership of the general practitioner in the postoperative period or the period of cervical immobilization could recognize possible malpositioning of the instrumentation, nonunion of the fracture, malsanation of the wound, and possible complications in case of the external immobilization. There is a lack of information on that topic. The goal of the paper is to summarise the most common fractures of the craniocervical region, their etiology, and treatment options and to present the results of our study of patients who underwent operative treatment for craniocervical fracture(s). Mastering the details, the treatment options, and the possible complication of the fractures in the craniocervical region, general practitioners could play an important role in the treatment of patients.

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Management of older adults after mild head trauma in an oral and maxillofacial surgery clinic

et al. 2023

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C1-C2 fractures in asymptomatic elderly patients with minor head trauma: evaluation with a dedicated head CT protocol

Cited by 6 publications

References 24 publications

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

Clinical Behavior of General Practitioners for Patients who Underwent an Operative or Conservative Treatment for a Craniocervical Fracture

Management of older adults after mild head trauma in an oral and maxillofacial surgery clinic

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