Occipital Condyle Fractures and Concomitant Cervical Spine Fractures: Implications for Management.

Occipital Condyle Fractures and Concomitant Cervical Spine Fractures: Implications for Management.

World Neurosurg. 2018 Apr 12;:

Authors: West JL, Palma AE, Vilella L, Fargen KM, Branch CL, Wolfe SQ

Abstract
INTRODUCTION: Occipital condyle fractures (OCFs) have previously been described based upon anatomic characteristics; however, recent literature has proposed management based on biomechanical stability and neural element compression. The treatment of biomechanically stable fractures varies between observation and cervical immobilization. Prior to determining best management, understanding of concomitant cervical spine fractures in the presence of OCFs is prudent. The primary aim of this pilot study was to determine the rate of occurrence of biomechanically significant cervical spine fractures with OCFs.
METHODS: A retrospective chart review was performed of 13,363 trauma patients presenting to a Level 1 trauma center from 2013 to 2017 for patients with the diagnosis of occipital condyle fracture.
RESULTS: 46 patients presented with OCF with average GCS 12 upon presentation and average Injury Severity Score of 23. The average age was 42.1 years and 4 patients were found to have bilateral OCFs. Approximately 30% of these patients had associated intracranial injuries, and 59% had an associated cervical spine injury. The overall rate of associated potentially biomechanically significant cervical spine fracture was 43.5%. Treatment of OCF included collar immobilization (83%) and observation (17%). Average follow up was 3.37 months.
CONCLUSION: This study characterizes cervical spine fractures which occur concomitantly with OCFs. The results indicate that over half of patients with OCFs do not have biomechanically significant fractures elsewhere in the cervical spine. This subset of patients will be the cohort for a prospective study to assess if collar immobilization is necessary.

PMID: 29656152 [PubMed - as supplied by publisher]

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