A total of 72 severe thoracic scoliokyphosis with major
curve (>90°) were included in the study; patients with cardiac
disease and lung disease were excluded. Patients were divided
into two subgroups according to the different directions of
the major curve. Another 72 adolescent idiopathic scoliosis
(AIS) patients with major curves were included in the study as
control group. Cardiac function and structure were analyzed
using echocardiographic and Holter electrocardiograms. Demographic traits — such age, sex, height and weight — and
Cobb angle were also analyzed.
“We found that severe thoracic scoliokyphosis has a limited
effect on cardiac function and structure; although left major
curve can affect the cardiac structure to some extent,” Dr.
Wang said. “The real threat is the poor lung function in severe
Mortality Rates Following Posterior C1-2 Fusion
for Treatment of Displaced Type II Odontoid
Fractures in Octogenarians: A Ten-Year Review
Stephen Clark, MD; Luke Brown, MD; Mark Shasti, MD; Eugene Y. Koh, MD,
PhD; Kelley E. Banagan, MD; Steven C. Ludwig, MD; Daniel E. Gelb, MD
This study aimed to analyze 30-day and one-year mortality
rates, as well as the most common complications associated
with posterior C1-2 fusion, to determine if surgical interven-
tion is a viable option for treatment of unstable Type II odon-
toid fractures in patients 80 years of age or greater.
This retrospective analysis included 41 consecutive pa-
tients who underwent posterior C1-C2 fusion for management
of unstable Type II odontoid fracture by four fellowship-
trained spine surgeons at a single institution between Janu-
ary 2006 and June 2016. Fall from standing accounted for 40
of 41 fractures with the other due to motor vehicle collision.
One patient had a neurologic deficit upon presentation. For
statistical analysis, Fischer’s Exact test and logistic regression
analysis were performed.
Based on their findings, the investigators in this study
report that posterior C1-2 fusion results in lower mortality
rate in octogenarians with displaced and/or angulated Type
II odontoid fracture. The initial fracture displacement and
postoperative dysphagia are associated with higher mortality
rate in this patient population.
“Odontoid fractures are the most common spinal injury
in octogenarian patients, with current trends indicating that
the incidence of this injury is increasing as this population is
continuing to grow,” said presenting author, Mark Shasti, MD.
Results showed “C1-C2 fusion had 2.3% and 18.6% mortality
at 30 days and one year between pts aged 80-89. Our results
showed displacement and postop dysphasia to be assicated
with mortaliy. These data suggest that C1-C2 fusion is a viable
treatment option for patients with this type of injury pattern.”