Hüseyin ÖZVEREN, Abdurrahman ÇETİN, SALİH HATTAPOĞLU

Clinical and morphological evaluation of odontoid fractures of C2 vertebra

There have not been enough studies on cervical vertebra-2 (C2) odontoid fracture and their clinical and radiological evaluation. This study was designed to determine the proportions of the C2 odontoid fracture types and to determine the specific incidence of fracture types according to age and gender and to evaluate them clinically and with cervical spine computed tomography (CT) sections of each case. We retrospectively reviewed 32 cases of C2 odontoid fractures admitted to our clinic between January 2013 and March 2017. There were C2 odontoid fracture [15 (46.9%) male and 17 (53.1%) female] who were referred to the neurosurgical clinic. The mean age was 38.5 (2-87). The most frequent reasons for application were in-vehicle traffic accidents 18 (56.3%), fall 6 (18.8%), outside-vehicle traffic accidents 4 (12.5%), assault 3 (9.4%), breast Ca. 1 (3.1%) due to metastasis. In terms of odontoid fracture types; Type I 4 (12.5%), Type II 23 (71.9%), Type III was 5 (15.6%). 13 (40.6%) anterior, 7 (21.9%) posterior and 12 (37.5%) nondeplase were applied for odontoid fracture displacement in our cases. Pain and tenderness in the neck region of 29 patients (90.6%) were present in C2 odontoid fractured patients who applied to our clinic, while 3 (9.4%) patients presented with hemiparesia. The Frankel scale of these patients; 1 patient (3.1%) applied with B, 2 (6.3%) with D, 29 (90.6%) with E scale. Odontoid fractures do not always come to us with spinal cord damage, often the initial sign may be only neck pain. In such cases, odontoid fractures can be easily misdiagnosed and can result in morbidity and mortality, which is a major problem. The aim of our study is to draw attention to the importance of this issue by evaluating the existing data on odontoid fractures in many aspects, which are not enough studies in the literature.

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