Traumatic occipito-cervical dissociation in adults: a Middle Eastern cohort study

Traumatic occipito-cervical dissociation in adults: a Middle Eastern cohort study The objective of this study is to describe a series of cranio-cervical dissociation victims and evaluate their outcomes as well as discuss the clinical dilemmas we faced in the context of current literature evidence. This is a retrospective cohort study of traumatic occipito-cervical dissociation in five patients (three males and two females) encountered between 2010 and 2016 at a tertiary care facility in the Middle East region. All patients underwent occipito-cervical fusion using screws and rods system with mean postoperative follow-up period of 2.5 years. All patients survived, and four were independently mobile and one wheel chair bound. Most had some degree of neurological sequelae, often due to associated injuries and all complained of limited neck range of motion. Contemporary literature review shows that CT scan with MRI is often the best diagnostic modality. Surgery is usually indicated though rare cases treated conservatively have been reported. The commonest predictor of mortality is missed injury, associated head injury and wide separation between the skull base and C1 on imaging studies. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Orthopaedic Surgery & Traumatology Springer Journals

Traumatic occipito-cervical dissociation in adults: a Middle Eastern cohort study

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Publisher
Springer Paris
Copyright
Copyright © 2017 by Springer-Verlag France SAS
Subject
Medicine & Public Health; Surgical Orthopedics; Traumatic Surgery
ISSN
1633-8065
eISSN
1432-1068
D.O.I.
10.1007/s00590-017-2053-2
Publisher site
See Article on Publisher Site

Abstract

The objective of this study is to describe a series of cranio-cervical dissociation victims and evaluate their outcomes as well as discuss the clinical dilemmas we faced in the context of current literature evidence. This is a retrospective cohort study of traumatic occipito-cervical dissociation in five patients (three males and two females) encountered between 2010 and 2016 at a tertiary care facility in the Middle East region. All patients underwent occipito-cervical fusion using screws and rods system with mean postoperative follow-up period of 2.5 years. All patients survived, and four were independently mobile and one wheel chair bound. Most had some degree of neurological sequelae, often due to associated injuries and all complained of limited neck range of motion. Contemporary literature review shows that CT scan with MRI is often the best diagnostic modality. Surgery is usually indicated though rare cases treated conservatively have been reported. The commonest predictor of mortality is missed injury, associated head injury and wide separation between the skull base and C1 on imaging studies.

Journal

European Journal of Orthopaedic Surgery & TraumatologySpringer Journals

Published: Oct 6, 2017

References

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