Paper| Volume 23, ISSUE 1, P38-40, 1992

The epidemiology of fractures and fracture-dislocations of the cervical spine

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      A total of 717 fractures and fracture-dislocations of the cervical spine occurred in 657 patients in a 13-year period. Injury was commonest in the third decade of life. The levels most frequently injured were the second, fifth, and sixth. Injuries of the first and second cervical vertebrae commonly occurred together, and injuries involving the upper and lower cervical spine in the same individual occurred in 9 per cent of patients with fractures of C1 and C2. Odontoid fractures were the most frequent fractures in patients over 70 years of age, and formed the majority of fractures in patients over 80 years of age. It is recommended that if a fracture of the upper cervical spine is seen on radiographs, another fracture in the upper or lower cervical spine should be excluded. Patients aged 70 years and above who complain of neck pain after trauma should be suspected of having an odontoid fracture, until proven otherwise.
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        • Althoff B.
        • Bardholm P.
        Fractures of the odontoid process. A clinical and radiographic study.
        Acta Orthop. Scand. 1979; : 61
        • Anderson L.D.
        • D'Alonso R.T.
        Fractures of the odontoid process of the axis.
        J. Bone Joint Surg. 1974; 56A: 1663
        • Bohlman H.H.
        Acute fractures and dislocations of the cervical spine.
        J. Bone Joint Surg. 1979; 61A: 1119
        • Clark C.R.
        • White A.A.
        Fractures of the dens, a multicentre study.
        J. Bone Joint Surg. 1985; 67A: 1340
        • Durbin F.C.
        Fracture-dislocations of the cervical spine.
        J. Bone Joint Surg. 1957; 39B: 23
        • Esses S.
        • Langer F.
        • Gross A.
        Fractures of the atlas associated with fracture of the odontoid process.
        Injury. 1981; 12: 310
        • Fielding J.W.
        • Francis W.R.
        • Hawkins R.J.
        • et al.
        Traumatic spondylolisthesis of the axis.
        Clin. Orthop. 1989; 239: 47
        • Hadley M.N.
        • Dickman C.A.
        • Browner C.M.
        • et al.
        Acute traumatic atlas fractures: management and long-term outcome.
        Neurosurgery. 1988; 23: 31
        • Horlyk E.
        • Rahbek M.
        Cervical spine injuries.
        Acta Orthop. Scand. 1974; 45: 845
        • Jefferson G.
        Fractures of the atlas vertebra; report of four cases, and a review of those previously recorded.
        Br. J. Surg. 1920; 7: 407
        • Korres D.S.
        • Katsaros A.
        • Pantazopoulos Th.
        • et al.
        Double or multiple level fractures of the spine.
        Injury. 1981; 13: 147
        • Lipson S.J.
        Fractures of the atlas associated with fractures of the odontoid process and transverse ligament ruptures.
        J. Bone Joint Surg. 1977; 59A: 940
        • Schatzker J.
        • Rorabeck C.H.
        • Waddell J.P.
        Fractures of the dens (odontoid process), an analysis of thirty-seven cases.
        J. Bone Joint Surg. 1971; 53B: 392
        • Shear P.
        • Hugenholtz H.
        • Richard M.T.
        • et al.
        Multiple non-contiguous fractures of the cervical spine.
        J. Trauma. 1988; 28: 655