Assessment of cervical range of motion in patients after axis fracture

Wolan-Nieroda, Andżelina; Maciejczak, Andrzej; Przysada, Grzegorz; Kużdżał, Adrian; Magoń, Grzegorz; Czarnota, Michalina; Drużbicki, Mariusz; Guzik, Agnieszka

doi:10.1016/j.pjnns.2017.11.013

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…The present study showed that rotation range of motion in cervical spine in the study group was highly statistically significantly limited in comparison to ISOM norms. Those results comply with our previous study showing that subjects treated surgically for odontoid fractures present statistically significant lower ranges of active motion of the cervical spine, particularly in axial rotation than the control group ( p < 0.001) 8 , 10 .…”

Section: Discussionsupporting

confidence: 93%

“…However, the most prominent of all motions at C1/C2 segment is axial rotation which reaches 45 degrees towards one side. It provides nearly half of total range of axial rotation of head against torso 8 – 10 . That is why we included this parameter into our analysis.…”

Section: Introductionmentioning

confidence: 99%

“…Based on literature review it can be concluded that the present study is the first to assess quality of life in relation to such factors as the range of cervical axial rotation, pain and disability and to investigate their adverse effects in self-assessed life satisfaction of patients following axis fracture. Motivation for the current study was inspired by our earlier research findings, which showed that subjects treated surgically for odontoid fractures present statistically significant lower ranges of active motion of the cervical spine, particularly in axial rotation than the healthy population 8 – 10 .…”

Section: Introductionmentioning

confidence: 99%

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Determinants of health-related quality of life in patients with fracture of the axis vertebrae

Wolan-Nieroda

Maciejczak

Drużbicki

et al. 2021

Sci Rep

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The study is designed to evaluate quality of life and functional performance in patients with type II and III odontoid fracture treated with anterior odontoid screw fixation. We investigated the relationship between quality of life and: (1) the range of axial rotation of the cervical spine, (2) neck pain intensity, and (3) level of disability in these patients. The study involved 60 patients operated on for type II and III fractures with the use of direct osteosynthesis of the dens. Quality of life and functional performance were assessed using SF-36 Questionnaire and Neck Disability Index (NDI). The range of axial rotation was examined with the use of the Zebris ultrasound system while the intensity of pain with the use of the VAS Visual Analog Pain Scale. The subjects’ quality of life was poorer with respect to the mental dimension (32.3%) compared to the physical dimension (22.7%). Based on the NDI survey, the rate representing the patients’ functioning in daily life amounted to 13.7% which reflects mild limitations in functional abilities. It was shown that the range of axial rotation (both to the right and the left) was not related to the degree of disability of patients as measured by the NDI questionnaire. The model of regression was statistically significant for overall quality of life (F = 48.24 p < 0.001), as well as physical dimension (F = 45.1 p < 0.001). Quality of life indicators in SF-36 are decreased in patients operated for type II and III odontoid fracture and the mental dimension of the quality of life is significantly poorer than the physical one. More than half of the patients operated for type II and III odontoid fracture regained normal functioning, as assessed with the NDI questionnaire.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determinants of health-related quality of life in patients with fracture of the axis vertebrae

Wolan-Nieroda

Maciejczak

Drużbicki

et al. 2021

Sci Rep

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“…From the viewpoint of spinal kinematics, direct osteosynthesis is the most effective method of surgical treatment of odontoid fractures. It is believed that, unlike posterior atlantoaxial fixation, the method preserves physiological range of motion in the upper cervical spine, which is responsible for nearly half of the entire range of motion of the head relative to the torso [1–3]. In the literature, there are no clinical studies focusing on cervical mobility in patients following anterior odontoid screw fixation or conservative treatment involving immobilization in external hard collar or in halo vest.…”

Section: Introductionmentioning

confidence: 99%

Range of motion in the cervical spine after odontoid fracture treated with anterior screw fixation

et al. 2019

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Background It is believed that direct odontoid screw fixation preserves the physiological cervical range of motion following surgery. However, there are no clinical studies confirming the motion sparing value of this technique. This study aims to (1) to assess active cervical range of motion following types II and III odontoid fracture, successfully treated with anterior odontoid screw fixation, and (2) to examine the relationship between the range of motion of the head and duration of collar usage, neck pain, quality of life, and patients’ age. Methods The study involved 41 patients subjected to a procedure of direct osteosynthesis of the dens with lag screw. Following the operation all the patients had to wear a cervical collar to protect the osteosynthesis. The control group consisted of 41 individuals with no clinical diagnosis of any cervical spine disorders. The spinal motion was assessed using multi-cervical unit, taking into account bending/extension, left and right lateral flexion, and left and right axial rotation. Results In the study group, spine mobility correlated with the duration of hard collar usage following the operation, with a longer duration corresponding to poorer spine mobility at the end of the treatment. Statistically significant correlation was observed in the case of extension ( p < 0.021) and axial rotation ( p < 0.007). In the study group, there was a negative correlation between the range of motion and the patients’ age, i.e., the older the patient the poorer his/her spinal mobility ( p < 0.001). Conclusions Active cervical range of motion in patients following direct osteosynthesis of the dens, augmented with a hard collar, was significantly lower than in the control population, and it correlated negatively with the duration of collar usage, the patients’ age, and intensity of spinal pain.

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“…Several studies had reported the effect of atlantoaxial fusion on the postoperative loss of cervical rotation and neck stiffness. In one study of thirty patients with odontoid fractures who underwent posterior atlantoaxial fusion, it was found that the mean physiological cervical ranges of motion were decreased in all planes after fusion [22]. Moreover, adjacent intervertebral disorders might occur after atlantoaxial articulations.…”

Section: Discussionmentioning

confidence: 99%

Reducible Nonunited Type II Odontoid Fracture with Atlantoaxial Instability: Outcomes of Two Different Fixation Techniques

Bunmaprasert

Trirattanapikul

Sugandhavesa

et al. 2021

IJERPH

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Displaced nonunited type II odontoid fracture can result in atlantoaxial instability, causing delayed cervical myelopathy. Both Magerl’s C1-C2 transarticular screw fixation technique and Harms-Goel C1-C2 screw-rod segmental fixation technique are effective techniques to provide stability. This study aimed to demonstrate the results of two surgical fixation techniques for the treatment of reducible nonunited type II odontoid fracture with atlantoaxial instability. Medical records of patients with reducible nonunited type II odontoid fracture hospitalized for spinal fusion between April 2007 and April 2018 were reviewed. For each patient, specific surgical fixation, either Magerl’s C1-C2 transarticular screw fixation technique augmented with supplemental wiring or Harms-Goel C1-C2 screw-rod fixation technique, was performed according to our management protocol. We reported the fusion rate, fusion period, and complications for each technique. Of 21 patients, 10 patients were treated with Magerl’s C1-C2 transarticular screw fixation technique augmented with supplemental wiring, and 11 were treated with Harms-Goel C1-C2 screw-rod fixation technique. The bony fusion rate was 100% in both groups. The median time to fusion was 69.7 (95%CI 53.1, 86.3) days in Magerl’s C1-C2 transarticular screw fixation technique and 75.2 (95%CI 51.8, 98.6) days in Harms-Goel C1-C2 screw-rod fixation technique. No severe complications were observed in either group. Displaced reducible, nonunited type II odontoid fracture with cervical myelopathy should be treated by surgery. Both fixation techniques promote bony fusion and provide substantial construct stability.

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Assessment of cervical range of motion in patients after axis fracture

Abstract: Odontoid fractures lead to limitations in mobility of the cervical spine even after treatment with methods that in theory should preserve the C1/C2 mobility.

Cited by 4 publications

References 19 publications

Determinants of health-related quality of life in patients with fracture of the axis vertebrae

Determinants of health-related quality of life in patients with fracture of the axis vertebrae

Range of motion in the cervical spine after odontoid fracture treated with anterior screw fixation

Reducible Nonunited Type II Odontoid Fracture with Atlantoaxial Instability: Outcomes of Two Different Fixation Techniques

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