The incidence of odontoid fractures following trauma in a major trauma center, a retrospective study

Sami Ibrahim AlEissa; Ali Abdullah Alhandi; Ahad Abdullah Bugis; Raghad Khalid Alsalamah; Abdulellah Alsheddi; Abdulaziz Khalid Almubarak; Suhail Saad AlAssiri; Faisal MohammedSaleh Konbaz

doi:10.4103/jcvjs.JCVJS_28_20

The incidence of odontoid fractures following trauma in a major trauma center, a retrospective study

J Craniovertebr Junction Spine. 2020 Apr-Jun;11(2):71-74. doi: 10.4103/jcvjs.JCVJS_28_20. Epub 2020 Jun 5.

Authors

Sami Ibrahim AlEissa^{1

2}, Ali Abdullah Alhandi¹, Ahad Abdullah Bugis³, Raghad Khalid Alsalamah², Abdulellah Alsheddi¹, Abdulaziz Khalid Almubarak^{2

4}, Suhail Saad AlAssiri¹, Faisal MohammedSaleh Konbaz¹

Affiliations

¹ Department of Surgery, Division of Orthopedics, King Abdulaziz Medical City, National Guard Health Affaires, Riyadh, Saudi Arabia.
² Collage of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
³ Collage of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.
⁴ King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

Abstract

Background: Cervical spine injury is the most common vertebral injury after major trauma, 20% of all cervical fractures happen to be odontoid fractures. In young adults, odontoid fracture usually happens as a result of high-energy trauma after a motor vehicle accident (MVA). MVA in Riyadh represents 38.4% of all trauma cases, in which the head-and-neck are the most injured body parts. This research aims to provide information about the incidence of odontoid process fracture post-MVA in Riyadh, Saudi Arabia.

Methods: The design of this study was retrospective. A single level one trauma center database (trauma registry) was used to identify odontoid fractures post-MVA. All trauma cases from 2008 to the most recent were included, a total of 17,047 patients, to identify cervical spine fractures and further identify odontoid fracture incidence. The patients' radiographs were reviewed retrospectively, and odontoid fractures were classified by a board-certified spine surgeon. A descriptive analysis was carried out to report basic data distribution. Pearson's correlation was carried out to assess associations.

Results: A total number of cervical spine fracture was 1195 patients (6.6% of the total sample). The incidence of odontoid fractures during the entire study period from 2008 to 2018 was 42 of 480 patients with C2 cervical trauma, constituting 8.75% C2 fractures, and 3.5% of cervical spine fractures. The mean age was 41.75 ± 18 years. There were three patients (onemale, two females) with type I odontoid fracture, 26 (all males) with type II, and 13 (11 males, 2 females) with type III. Most patients were managed conservatively (83.33%), whereas 16.67% underwent surgical management.

Conclusion: The incidence of posttraumatic odontoid fractures is low, given the younger population of this study. This does not predict future incidence rates with the continued improvement of road traffic laws and awareness in the population.

Keywords: Cervical; fractures; motor vehicle accident; odontoid; spine; trauma.