Recommendations for Diagnosis and Treatment of Fractures of the Ring of Axis
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Recommendations for Diagnosis and Treatment of Fractures of the Ring of Axis : Axisringfrakturen. / Scholz, Matti; Schleicher, Philipp; Kandziora, Frank; Badke, Andreas; Dreimann, Marc; Gebhard, Harry; Gercek, Erol; Gonschorek, Oliver; Hartensuer, René; Jarvers, Jan-Sven Gilbert; Katscher, Sebastian; Kobbe, Philipp; Koepp, Holger; Korge, Andreas; Matschke, Stefan; Mörk, Sven; Müller, Christian W; Osterhoff, Georg; Pécsi, Ferenc; Pishnamaz, Miguel; Reinhold, Maximilian; Schmeiser, Gregor; Schnake, Klaus John; Schneider, Kristian; Spiegl, Ulrich Josef Albert; Ullrich, Bernhard.
In: Z ORTHOP UNFALLCHIR, Vol. 156, No. 6, 12.2018, p. 662-671.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Recommendations for Diagnosis and Treatment of Fractures of the Ring of Axis
T2 - Axisringfrakturen
AU - Scholz, Matti
AU - Schleicher, Philipp
AU - Kandziora, Frank
AU - Badke, Andreas
AU - Dreimann, Marc
AU - Gebhard, Harry
AU - Gercek, Erol
AU - Gonschorek, Oliver
AU - Hartensuer, René
AU - Jarvers, Jan-Sven Gilbert
AU - Katscher, Sebastian
AU - Kobbe, Philipp
AU - Koepp, Holger
AU - Korge, Andreas
AU - Matschke, Stefan
AU - Mörk, Sven
AU - Müller, Christian W
AU - Osterhoff, Georg
AU - Pécsi, Ferenc
AU - Pishnamaz, Miguel
AU - Reinhold, Maximilian
AU - Schmeiser, Gregor
AU - Schnake, Klaus John
AU - Schneider, Kristian
AU - Spiegl, Ulrich Josef Albert
AU - Ullrich, Bernhard
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2018/12
Y1 - 2018/12
N2 - In a consensus process with four sessions in 2017, the working group "upper cervical spine" of the German Society for Orthopaedics and Trauma Surgery (DGOU) formulated "Therapeutic Recommendations for the Diagnosis and Treatment of Upper Cervical Fractures", taking their own experience and the current literature into consideration. The following article describes the recommendations for axis ring fractures (traumatic spondylolysis C2). About 19 to 49% of all cervical spine injuries include the axis vertebra. Traumatic spondylolysis of C2 may include potential discoligamentous instability C2/3. The primary aim of the diagnostic process is to detect the injury and to determine potential disco-ligamentous instability C2/3. For classification purposes, the Josten classification or the modified Effendi classification may be used. The Canadian C-spine rule is recommended for clinical screening for C-spine injuries. CT is the preferred imaging modality and an MRI is needed to determine the integrity of the discoligamentous complex C2/3. Conservative treatment is appropriate in case of stable fractures with intact C2/3 motion segment (Josten type 2 and 2). Patients should be closely monitored, in order to detect secondary dislocation as early as possible. Surgical treatment is recommended in cases of primary severe fracture dislocation or discoligamentous instability C2/3 (Josten 3 and 4) and/or secondary fracture dislocation. Anterior cervical decompression and fusion (ACDF) C2/3 is the treatment of choice. However, in case of facet joint luxation C2/3 with looked facet (Josten 4), a primary posterior approach may be necessary.
AB - In a consensus process with four sessions in 2017, the working group "upper cervical spine" of the German Society for Orthopaedics and Trauma Surgery (DGOU) formulated "Therapeutic Recommendations for the Diagnosis and Treatment of Upper Cervical Fractures", taking their own experience and the current literature into consideration. The following article describes the recommendations for axis ring fractures (traumatic spondylolysis C2). About 19 to 49% of all cervical spine injuries include the axis vertebra. Traumatic spondylolysis of C2 may include potential discoligamentous instability C2/3. The primary aim of the diagnostic process is to detect the injury and to determine potential disco-ligamentous instability C2/3. For classification purposes, the Josten classification or the modified Effendi classification may be used. The Canadian C-spine rule is recommended for clinical screening for C-spine injuries. CT is the preferred imaging modality and an MRI is needed to determine the integrity of the discoligamentous complex C2/3. Conservative treatment is appropriate in case of stable fractures with intact C2/3 motion segment (Josten type 2 and 2). Patients should be closely monitored, in order to detect secondary dislocation as early as possible. Surgical treatment is recommended in cases of primary severe fracture dislocation or discoligamentous instability C2/3 (Josten 3 and 4) and/or secondary fracture dislocation. Anterior cervical decompression and fusion (ACDF) C2/3 is the treatment of choice. However, in case of facet joint luxation C2/3 with looked facet (Josten 4), a primary posterior approach may be necessary.
U2 - 10.1055/a-0620-9170
DO - 10.1055/a-0620-9170
M3 - SCORING: Journal article
C2 - 29933496
VL - 156
SP - 662
EP - 671
JO - Z ORTHOP UNFALLCHIR
JF - Z ORTHOP UNFALLCHIR
SN - 1864-6697
IS - 6
ER -