The magnitude of angular and translational displacement of dens fractures is dependent on the sagittal alignment of the cervical spine rather than the force of injury

Blizzard, Sabina R.; Krishnamoorthy, Bala; Shinseki, Matthew; Betsch, Marcel; Yoo, Jung U.

doi:10.1016/j.spinee.2017.06.021

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…The overall cervical sagittal morphology likely impacts the degree of displacement, potentially increasing the risk of failure of the AOSF construct. 29 Unfortunately, such information could not be obtained from the database.…”

Section: Discussionmentioning

confidence: 99%

“…We were unable to compare displaced versus nondisplaced type II fractures as the ICD-10 code which distinguishes them was developed in 2016; as such, all fractures categorized before 2016 would be removed from the data set, leaving an insufficient amount of data to perform statistical analysis on all groups. The overall cervical sagittal morphology likely impacts the degree of displacement, potentially increasing the risk of failure of the AOSF construct 29 . Unfortunately, such information could not be obtained from the database.…”

Section: Discussionmentioning

confidence: 99%

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Surgeon Experience Is the Most Important Predictor of Case Failure Rate for Anterior Odontoid Screw Fixation

Fan,

Sauer,

Kark

et al. 2024

Clinical Spine Surgery

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Study Design: Retrospective database analysis. Objective: Determine risk factors and failure rate of anterior odontoid screw fixation surgery. Summary of Background Data: Anterior odontoid screw fixation (AOSF) stabilizes type II dens fractures while preserving cervical motion. Despite having potential advantages, AOSF’s failure rate and factors contributing to failure remain unknown. Materials and Methods: We identified AOSF patients in the national claims database Pearldiver using CPT code 22318. Failure was defined as the requirement of supplementary posterior fusion surgery in the C1–C2 or occiput-C2 region after the AOSF. We considered potential predictors of failure including age, sex, Charlson Comorbidity Index (CCI), surgeon experience, history of osteoporosis, obesity, and tobacco use. Univariate comparison analysis and logistic regression were conducted to identify factors associated with the need for additional posterior surgery. Results: For 2008 identified cases of AOSF, 249 cases (12.4%) required additional posterior fusion. Seventy-one of the 249 cases (28.5%) underwent revision surgery on the same day as the AOSF. Over 86% of revisions (215 cases) occurred within 200 days of the initial procedure. Posterior fusion rates are inversely correlated with surgeon experience, with the most experienced surgeons having a rate of 10.0%, followed by 11.5% for moderately experienced surgeons, and 15.0% for the least experienced surgeons. When comparing moderate and inexperienced surgeons to experienced surgeons, the odds ratios for posterior fusion were 1.18 (P>0.05) and 1.61 (P<0.006), respectively. Logistic regression revealed that both lesser experience (odds ratio=1.50) and osteoporosis (odds ratio=1.44) were the only factors significantly associated with failure (P<0.05). Conclusions: Our findings indicate a correlation between AOSF success and surgeon experience. While currently published results suggest higher success rates, most of this data originates from experienced surgeons and specialized centers, therefore, they may not accurately reflect the failure rate encountered in a more general practice setting. Level of evidence: Level III.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgeon Experience Is the Most Important Predictor of Case Failure Rate for Anterior Odontoid Screw Fixation

Fan,

Sauer,

Kark

et al. 2024

Clinical Spine Surgery

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“…Disruption of cervical sagittal alignment was implicated in the development of various spinal disorders [1][2][3]. And severe cervical sagittal imbalance declined the patient's health-related quality of life [4,5] and even lead to disability through compressing the spinal cord [6,7].…”

Section: Introductionmentioning

confidence: 99%

The Change of Cervical Spine Alignment Along with BMI in Asymptomatic Population: A Preliminary Analysis

Shao

Dai

Zhao

et al. 2020

Preprint

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Study design: A cross-sectional studyObjective:Describe the difference in the cervical sagittal alignment between various BMI people.Summary of Background Data:Cervical sagittal imbalance is implicated in the development of various spinal disorders, and obesity was recognized as a global epidemic. But there were few studies focusing on the correlation between cervical sagittal alignment and body mass index (BMI). Methods: This study enrolled 140 asymptomatic volunteers from July 2016 to July 2019. Demographic data included gender, age and BMI, and radiographic parameters included chin–brow vertical angle (CBVA), occipital slope (OS), orbital tilt (OrT), orbital index (OI), occiput-C2 lordosis (O-C2), cervical lordosis (CL), C2-C7 sagittal vertical axis (C2-C7SVA) , cranial tilting (CrT), cervical tilting (CeT), T1 slope (TS), neck tilt (NT), and thoracic inlet angle (TIA). The data were analyzed by ANOVA statistical analyses.Results: In terms of the occipitocervical parameters, we found that there was no significant difference (OS, P=0.970; OrT, P=0.970; OI, P=0.798); In terms of cervical parameters, we found significant correlations between BMI and parameters (C2-C7SVA, P=0.005; TZC2-C7, P=0.030; CrT, P= 0.050; CeT, P=0.013), which reflected that forward head posture increases as BMI rises; In terms of thoracic parameters, we also found significant correlations between BMI and parameters (NT, P=0.014; TIA, P=0.050), which reflected that thoracic inlet lifts as BMI rises.Conclusions: We found that there are the correlations between cervical sagittal alignment (C2-C7SVA, TZC2-C7, CL, CrT, and CeT) and BMI, and forward head posture increases and thoracic inlet lifts in the obese, which can provide clinical advice and remind surgeons of BMI effect in reconstructive surgery for better prognoses.

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Odontoid fracture type and angulation affect nonunion risk, but comminution and displacement do not: A propensity score matched analysis of fracture morphology

Cloney,

Thirunavu,

Roumeliotis

et al. 2023

Clinical Neurology and Neurosurgery

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The magnitude of angular and translational displacement of dens fractures is dependent on the sagittal alignment of the cervical spine rather than the force of injury

Cited by 4 publications

References 24 publications

Surgeon Experience Is the Most Important Predictor of Case Failure Rate for Anterior Odontoid Screw Fixation

Surgeon Experience Is the Most Important Predictor of Case Failure Rate for Anterior Odontoid Screw Fixation

The Change of Cervical Spine Alignment Along with BMI in Asymptomatic Population: A Preliminary Analysis

Odontoid fracture type and angulation affect nonunion risk, but comminution and displacement do not: A propensity score matched analysis of fracture morphology

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