open access
Treatment of the dens fractures in children
open access
Abstract
The anatomical and biomechanical features of the immature cervical spine make the upper segments at C1–3 especially susceptible to injury.
Material and methodFrom 2000 to 2016, 10 patients (3 boys, 7 girls) with C2 dens fractures were treated. The average age of each child was 11 years (3–17). According to the Anderson classification, there were 6 patients with a type III fracture and 4 with a type II. 4 patients were treated conservatively using the Minerva cervical brace for 75 days (66–125) and 6 patients by means of the Halo-Vest for 79 days (64–87) and followed by the Schantz collar for 17 days (2–35).
ResultsThe follow up lasted 78 months (12–180). The NDI (Neck Disability Index) score was calculated for each patient, except for section 8 (driving the car). The scores ranged from 1/45 (2.22%) to 20/45 (44.44%). The mean score for 9 out of the 10 patients (one patient died) was 4.77 (10.61%).
ConclusionThe C2 dens fracture is a rare injury in children. The classification system of dens fractures developed by Anderson is useful in choosing the mode of treatment of dens fractures.
Abstract
The anatomical and biomechanical features of the immature cervical spine make the upper segments at C1–3 especially susceptible to injury.
Material and methodFrom 2000 to 2016, 10 patients (3 boys, 7 girls) with C2 dens fractures were treated. The average age of each child was 11 years (3–17). According to the Anderson classification, there were 6 patients with a type III fracture and 4 with a type II. 4 patients were treated conservatively using the Minerva cervical brace for 75 days (66–125) and 6 patients by means of the Halo-Vest for 79 days (64–87) and followed by the Schantz collar for 17 days (2–35).
ResultsThe follow up lasted 78 months (12–180). The NDI (Neck Disability Index) score was calculated for each patient, except for section 8 (driving the car). The scores ranged from 1/45 (2.22%) to 20/45 (44.44%). The mean score for 9 out of the 10 patients (one patient died) was 4.77 (10.61%).
ConclusionThe C2 dens fracture is a rare injury in children. The classification system of dens fractures developed by Anderson is useful in choosing the mode of treatment of dens fractures.
Keywords
Dens fractures, Treatment, Children, Spinal cord, Halo-Vest
Title
Treatment of the dens fractures in children
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
618-622
Published online
2018-09-01
Page views
593
Article views/downloads
692
DOI
10.1016/j.pjnns.2018.08.007
Bibliographic record
Neurol Neurochir Pol 2018;52(5):618-622.
Keywords
Dens fractures
Treatment
Children
Spinal cord
Halo-Vest
Authors
Ryszard Tomaszewski
Tomasz Koszutski