{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T03:23:12Z","timestamp":1785813792713,"version":"3.56.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>\n                    Odontoid fractures are common, often presenting in the elderly after a fall and infrequently associated with traumatic spinal cord injury (tSCI). The goal of this study was to analyze predictors of mortality and neurological outcome when odontoid fractures were associated with signal change on magnetic resonance imaging (MRI) at admission. Over an 18-year period (2001\u20132019), 33 patients with odontoid fractures and documented tSCI on MRI were identified. Mean age was 65.3 years (standard deviation [SD]\u2009=\u200917.2), and 21 patients were male. The mechanism of injury was falls in 25 patients, motor vehicle accidents in 5, and other causes in 3. Mean Injury Severity Score (ISS) was 40.5 (SD\u2009=\u200930.2), Glasgow Coma Scale (GCS) score was 13 (SD\u2009=\u20093.4), and American Spinal Injury Association (ASIA) motor score (AMS) was 51.6 (SD\u2009=\u200942.7). ASIA Impairment Scale (AIS) grade was A, B, C, and D in 9, 2, 3, and 19 patients, respectively. Mean intramedullary lesion length was 32.3\u2009mm (SD\u2009=\u200918.6). The odontoid peg was displaced ventral or dorsal in 15 patients. Twenty patients had surgical intervention: anterior odontoid screw fixation in 7 and posterior spinal fusion in 13. Eleven (33.3%) patients died in this series: withdrawal of medical care in 5; anoxic brain injury in 4; and failure of critical care management in 2. Univariate logistic regression indicated that GCS score (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.014), AMS (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.002), AIS grade (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.002), and ISS (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.009) were risk factors for mortality. Multi-variate regression analysis indicated that only AMS (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.002) had a significant relationship with mortality when odontoid fracture was associated with tSCI (odds ratio, 0.963; 95% confidence interval, 0.941\u20130.986).\n                  <\/jats:p>","DOI":"10.1089\/neur.2023.0005","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T13:51:00Z","timestamp":1685627460000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Mortality in ASIA Impairment Scale grade A to D Patients With Odontoid Fracture and Magnetic Resonance Imaging Evidence of Spinal Cord Injury"],"prefix":"10.1177","volume":"4","author":[{"given":"Bizhan","family":"Aarabi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Connecticut Children's, Hartford, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Harrop","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jefferson Medical College, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery and Spine Program, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Toups","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas, Houston at Methodist Hospital, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Guest","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, the Miami Project to Cure Paralysis, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Ugiliweneza","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kentucky Spinal Cord Injury Research Center, Louisville, Kentucky, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noori","family":"Akhtar-Danesh","sequence":"additional","affiliation":[{"name":"School of Nursing and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shekar N.","family":"Kurpad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Grossman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas, Houston at Methodist Hospital, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1989.71.5.0642"},{"key":"e_1_3_4_3_2","first-page":"821565","article-title":"An odontoid fracture causing apnea, cardiac instability, and quadriplegia","volume":"2012","author":"Bowers CA","year":"2012","unstructured":"Bowers CA, , Jost GF, , Dailey AT. 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