Characteristics and Management of Emergency Department Patients Presenting with C2 Cervical Spine Fractures. (15th May 2019)

• Record Type: Journal Article
• Authors: Tadros, Allison; Sharon, Melinda; Craig, Kristen; Krantz, William
• Other Names: Rodgers William B. Academic Editor.
• Is Part Of: BioMed research international. Volume 2019(2019)
• Publication Date: 2019-05-15
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2019/4301051
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Background . C2 cervical fractures account for approximately 18% of cervical spine injuries. Few studies have examined patients presenting to an emergency department (ED) with this injury relative to demographics, injury mechanism, and hospital course. Objectives . To compare multiple variables of ED patients presenting with these types of injuries. Methods . In this retrospective cohort study, data were obtained from the Trauma Registry of an academic trauma referral center from January 1, 2011, to December 31, 2015. Patients who presented with a C2 fracture were identified. Information regarding the patient's gender, age, mechanism of injury, associated injuries, if a procedure was required, disposition, and mortality was extracted. Comparative analyses were conducted between cases over or under age 60. Results . Between January 1, 2011, to December 31, 2015, a total of 139 patients with C2 fractures were identified. Most patients were 60 years or older (79%). Of those, 62% were female, and falls were the most common mechanism (78%). Of those under 60, 50% were female and motor vehicle crashes (MVCs) were the most common mechanism (71%). Odontoid fractures comprised 84% of C2 fractures. Only 6% had an associated spinal cord injury. Less than one-third of patients required operative intervention for their spinal injuries, and intervention was more common in older patients. Following admission, 19% of patients required placement into a nursing home or skilled nursing facility. Conclusions . C2 fractures are more common in older adults and usually resulted from falls. Odontoid fractures are most common. Most C2 fractures do not result in neurologic injury, and only a third were treated surgically. However, several patients were unable to return to their homes following their injury.