gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Surgical treatment of C2 fractures in geriatric patients

Chirurgische Behandlung der C2-Frakturen beim geriatrischen Patienten

Meeting Abstract

  • corresponding author Vasilios Zountsas - Krankenanstalten Gilead gGmbH, Neurochirurgische Klinik, Bielefeld
  • O. Schneider - Krankenanstalten Gilead gGmbH, Neurochirurgische Klinik, Bielefeld
  • H.-J. Hoff - Krankenanstalten Gilead gGmbH, Neurochirurgische Klinik, Bielefeld
  • F. Oppel - Krankenanstalten Gilead gGmbH, Neurochirurgische Klinik, Bielefeld

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.03.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0169.shtml

Published: April 23, 2004

© 2004 Zountsas et al.
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Outline

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Objective

To evaluate the surgical results, the outcome and the complication rate in a series of geriatric patients with unstable fractures of C2. Are these results good enough to justify the indication to operate on such patients?

Methods

Retrospective analysis of clinical and radiological data, of a series of 18 patients, which were operated in our institution in a 4 year period (2000-2003). The diagnosis of unstable C2 fracture was the indication of operation.

Results

Mean age of this group of patients was 81 years, with a range between 71-91 years. The woman to men ratio is 2:1. 12 patients were admitted without motor deficits. We applied two surgical methods. 10 patients were operated by a ventral approach according to the Knöriger screw fixation technique and 8 of them by a dorsal approach applying the Magerl technique. No major complications related to the surgery were observed. We re-operated on a patient due to screw dislocation one month after a dorsal C1/C2 fixation. In our series we had 4 deaths in the early postoperative period (10-15 days post-OP), 2 of these were patients with very bad preoperative condition. A patient underwent a stroke 8 days after the operation despite full mobilisation at the first post-OP day.

Conclusions

With operative stabilisation of C2 fractures we achieve an early mobilisation of the patients, without an external orthosis. The ventral screw fixation, which is a minimally invasive operation, is sufficient in the most of the Anderson and D' Alonzo type II fractures of the odontoid process. The dorsal C1/C2 stabilisation is a more extended operation and predisposes a good condition of the patient.