Journal article
The magnitude of angular and translational displacement of dens fractures is dependent on the sagittal alignment of the cervical spine rather than the force of injury
The spine journal, Vol.17(12), pp.1859-1865
12/2017
Handle:
https://hdl.handle.net/2376/107885
PMID: 28694217
Abstract
Although it is generally believed that the magnitude of dens fracture displacement is proportional to the amount of force applied to the cervical spine during injury, the factors responsible for displacement have not been studied.
Our aim was to determine factors that contribute to horizontal and angular displacement of dens fractures.
We conducted a retrospective review of adult patients who were admitted to our level 1 trauma center between January 1, 2008 and December 31, 2013.
Angular and horizontal displacements of the fractured dens in 57 patients were measured. Subjects were grouped based on mechanism of fracture: motor vehicle accident, ground level fall, and higher falls.
Cervical lordosis was measured between C2 and T1. C3-C4, C4-C5, C5-C6, and C6-C7 disc inclination angles were measured. Anteroposterior sagittal balance was assessed by comparing the sagittal position of the C2 body with the C7 body.
Data were analyzed using Pearson correlations, independent t tests, and support vector regression to construct predictive models that determine factors contributing to the angular and horizontal displacements.
The mean horizontal displacement of the fractured dens was not significantly different among groups. However, the dens in those with ground level falls had a significantly greater mean fracture angle compared with the higher energy trauma groups (p=.01). There were positive correlations between angular displacement and C5-C6 disc space inclination angle (r=0.67, p<.01) and C6-C7 disc space inclination angle (r=0.61, p<.01). There were positive correlations between horizontal displacement and C6-C7 inclination angle (r=0.40, p<.01) and sagittal alignment (r=0.32, p<.01). The predictive model using all variables demonstrated that angular fracture displacement was only dependent on C5-C6 disc space inclination angle. Horizontal displacement was only dependent on C6-C7 inclination angle and anteroposterior sagittal balance.
Disc space inclination angles of the lower cervical spine and the cervical sagittal balance most contribute to the magnitude of angular and horizontal displacement of the dens after fracture.
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Details
- Title
- The magnitude of angular and translational displacement of dens fractures is dependent on the sagittal alignment of the cervical spine rather than the force of injury
- Creators
- Sabina R Blizzard - Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USABala Krishnamoorthy - Department of Mathematics and Statistics, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, USAMatthew Shinseki - Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USAMarcel Betsch - Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USAJung Yoo - Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA. Electronic address: yooj@ohsu.edu
- Publication Details
- The spine journal, Vol.17(12), pp.1859-1865
- Academic Unit
- Mathematics and Statistics, Department of
- Publisher
- United States
- Identifiers
- 99900546940701842
- Language
- English
- Resource Type
- Journal article