{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T16:26:07Z","timestamp":1722961567136},"reference-count":26,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Einstein (S\u00e3o Paulo)"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>ABSTRACT Objective To evaluate the correlation between the treatment, the characteristics of the lesions and the clinical outcome of patients with traumatic injuries to the craniocervical junction. Methods This was a retrospective study of patients treated conservatively or surgically between 2010 and 2013 with complete data sets. Results We analyzed 37 patients, 73% were men with mean age of 41.7 years. Of these, 32% were submitted to initial surgical treatment and 68% received conservative treatment. Seven (29%) underwent surgery subsequently. In the surgical group, there were seven cases of odontoid type II fractures, two cases of fracture of posterior elements of the axis, one case of C1-C2 dislocation with associated fractured C2, one case of occipitocervical dislocation, and one case of combined C1 and C2 fractures, and facet dislocation. Only one patient had neurological d\u00e9ficit that improved after treatment. Two surgical complications were seen: a liquoric fistula and one surgical wound infection (reaproached). In the group treated conservatively, odontoid fractures (eight cases) and fractures of the posterior elements of C2 (five cases) were more frequent. In two cases, in addition to the injuries of the craniocervical junction, there were fractures in other segments of the spine. None of the patients who underwent conservative treatment presented neurological deterioration. Conclusion Although injuries of craniocervical junction are relatively rare, they usually involve fractures of the odontoid and the posterior elements of the axis. Our results recommend early surgical treatment for type II odontoid fractures and ligament injuries, the conservative treatment for other injuries.<\/jats:p>","DOI":"10.1590\/s1679-45082016ao3396","type":"journal-article","created":{"date-parts":[[2017,1,7]],"date-time":"2017-01-07T21:33:10Z","timestamp":1483824790000},"page":"528-533","source":"Crossref","is-referenced-by-count":2,"title":["Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction"],"prefix":"10.1590","volume":"14","author":[{"given":"Luiz Adriano","family":"Esteves","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Universidade Estadual de Campinas, Brazil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei Fernandes","family":"Joaquim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helder","family":"Tedeschi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"N\u00facleo do Hospital de For\u00e7a A\u00e9rea de S\u00e3o Paulo, Brazil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"261","article-title":"Epidemiologic features of head and spinal cord injury","volume":"19","author":"Kraus JF","year":"1978","journal-title":"Adv Neurol"},{"issue":"10","key":"ref2","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1007\/s00381-008-0606-8","article-title":"Anatomy and biomechanics of normal craniovertebral junction (a) and biomechanics of stabilization (b)","volume":"24","author":"Menezes AH","year":"2008","journal-title":"Childs Nerv Syst"},{"issue":"1","key":"ref3","first-page":"1","article-title":"The biomechanics of spinal injuries","volume":"11","author":"Sances Jr A","year":"1984","journal-title":"Crit Rev Biomed Eng"},{"issue":"4","key":"ref4","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1055\/s-0038-1625543","article-title":"Trauma raquimedular craniocervical: Revis\u00e3o de literatura","volume":"27","author":"Botelho RV","year":"2008","journal-title":"Arq Bras Neuro"},{"key":"ref5","first-page":"407","article-title":"Guidelines for the management of acute cervical spine and spinal cord injuries","volume":"49","author":"Hadley MN","year":"2002","journal-title":"Clin Neurosurg"},{"issue":"8","key":"ref6","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.2106\/00004623-197456080-00017","article-title":"Fractures of the odontoid process of the axis","volume":"56","author":"Anderson LD","year":"1974","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1302\/0301-620X.63B3.7263741","article-title":"Fractures of the ring of the axis. A classification based on the analysis of 131 cases","volume":"63-B","author":"Effendi B","year":"1981","journal-title":"J Bone Joint Surg Br"},{"issue":"6","key":"ref8","doi-asserted-by":"publisher","first-page":"863","DOI":"10.3171\/jns.1986.65.6.0863","article-title":"Traumatic atlanto-occipital dislocation Case report","volume":"65","author":"Traynelis VC","year":"1986","journal-title":"J Neurosurg"},{"issue":"4","key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/01.CSS.0000369800.29075.c8","article-title":"Occipito cervical trauma: evaluation, classification and treatment","volume":"11","author":"Joaquim AF","year":"2010","journal-title":"Contemp Spine Surg"},{"issue":"1","key":"ref10","doi-asserted-by":"publisher","first-page":"16","DOI":"10.4103\/0974-8237.151585","article-title":"Upper cervical injuries: clinical results using a new treatment algorithm","volume":"6","author":"Joaquim AF","year":"2015","journal-title":"J Craniovertebr Junction Spine"},{"issue":"9","key":"ref11","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.2106\/00004623-198567090-00006","article-title":"Fractures of the dens. A multicenter study","volume":"67","author":"Clark CR","year":"1985","journal-title":"J Bone Joint Surg Am"},{"key":"ref12","first-page":"41","article-title":"Evidence-based management of type II odontoid fractures","volume":"44","author":"Traynelis V","year":"1997","journal-title":"Clin Neurosurg"},{"issue":"6","key":"ref13","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2000.8.6.2","article-title":"Evidence-based analysis of odontoid fracture management","volume":"8","author":"Julien TD","year":"2000","journal-title":"Neurosurg Focus"},{"issue":"6","key":"ref14","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1016\/S0090-3019(98)00136-0","article-title":"Posterior C1-C2 transarticular screw fixation in the treatment of displaced type II odontoid fractures in the geriatric population--review of seven cases","volume":"51","author":"Campanelli M","year":"1999","journal-title":"Surg Neurol"},{"issue":"2","key":"ref15","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1007\/s005860050221","article-title":"Surgical treatment of nonunited fractures of the odontoid process, with special reference to occiptocervical fusion for unreductible atlantoaxial subluxation or instability","volume":"9","author":"Dai LY","year":"2000","journal-title":"Eur Spine J"},{"issue":"2","key":"ref16","first-page":"56","article-title":"Dens fracture in elderly patients and surgical management","volume":"24","author":"Pitzen T","year":"1994","journal-title":"Aktuelle Traumatol"},{"issue":"9","key":"ref17","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/j.1445-2197.2010.05586.x","article-title":"Risk factors for non-union in the non-operative management of type II dens fractures","volume":"81","author":"Lewis E","year":"2011","journal-title":"ANZ J Surg"},{"issue":"1","key":"ref18","doi-asserted-by":"publisher","first-page":"71","DOI":"10.2106\/JBJS.G.01347","article-title":"Incidence of and risk factors for complications associated with halo-vest immobilization: a prospective, descriptive cohort study of 239 patients","volume":"91","author":"van Middendorp JJ","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"ref19","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s00586-005-0918-2","article-title":"A systematic review of the management of hangman\u2019s fractures","volume":"15","author":"Li XF","year":"2006","journal-title":"Eur Spine J"},{"issue":"2","key":"ref20","first-page":"61","article-title":"Traumatic spondylolisthesis of the axis: 42 cases","volume":"60","author":"Moon MS","journal-title":"Bull Hoap Jt Dis"},{"issue":"266","key":"ref21","first-page":"64","article-title":"Lower cranial nerve palsies. Potentially lethal in association with upper cervical fracture-dislocations","author":"Hammer AJ","year":"1991","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"ref22","first-page":"95","article-title":"Forms of fractures of the occipital condyles","volume":"99","author":"Saternus KS","year":"1987","journal-title":"Z Rechtsmed"},{"issue":"1","key":"ref23","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1227\/00006123-198807000-00007","article-title":"Acute traumatic atlas fractures: management and long term outcome","volume":"23","author":"Hadley MN","year":"1988","journal-title":"Neurosurgery"},{"issue":"4","key":"ref24","doi-asserted-by":"publisher","first-page":"887","DOI":"10.2214\/ajr.162.4.8141013","article-title":"Radiologic diagnosis of traumatic occipitovertebral dissociation: 2. Comparison of three methods of detecting occipitovertebral relationships on lateral radiographs of supine subjects","volume":"162","author":"Harris Jr JH","year":"1994","journal-title":"AJR Am J Roentgenol"},{"issue":"1","key":"ref25","doi-asserted-by":"publisher","first-page":"32","DOI":"10.3171\/jns.1993.78.1.0032","article-title":"Odontoid fractures in elderly patients","volume":"78","author":"Hanigan WC","year":"1993","journal-title":"J Neurosurg"},{"issue":"9","key":"ref26","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1007\/s00256-005-0904-0","article-title":"Displaced fracture through the anterior atlantal synchondrosis","volume":"34","author":"Thakar C","year":"2005","journal-title":"Skeletal Radiol"}],"container-title":["Einstein (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/eins\/v14n4\/1679-4508-eins-14-04-0528.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,17]],"date-time":"2019-09-17T08:04:02Z","timestamp":1568707442000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1679-45082016000400528&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,12]]}},"alternative-id":["S1679-45082016000400528"],"URL":"https:\/\/doi.org\/10.1590\/s1679-45082016ao3396","relation":{},"ISSN":["1679-4508"],"issn-type":[{"type":"electronic","value":"1679-4508"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}