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首页> 外文期刊>Journal of neurosurgical sciences >Odontoid fractures in the octogenarian: a systematic review and meta-analysis
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Odontoid fractures in the octogenarian: a systematic review and meta-analysis

机译：八十形骨折在八十一骨折：系统审查和荟萃分析

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INTRODUCTION: Odontoid fractures (OF) are the most frequent cervical spine fracture type in the elderly, often following low-velocity falls. The rise in life expectancies has led to an increase in octogenarians suffering OF, for which the optimal treatment remains undetermined. EVIDENCE ACQUISITION: A comprehensive search was conducted (National Library of Medicine MEDLINE, Cochrane Central Register of Controlled Trials) for all articles through 03/2016. Articles were included if the study population evaluated treatment modalities in OF patients aged ≥80-years. Outcomes assessed were mortality, complications, osseous union, and fracture stability. Pooled odds ratios (OR) and 95% confidence intervals (Cl) are reported.EVIDENCE SYNTHESIS: Across 22 case series/retrospective studies, attributable mortality for surgery was 5.4% (8/149) vs. 10.1% (10/99) for nonsurgery (P=0.159). Surgery patients suffered higher complications rates (38.9%, 58/149; V5. 24.5%, 26/106); OR 1.96 ([1.13-3.40], P=0.016). Osseous union was better achieved with surgery (68.5%, 37/54; w. 43.2%, 16/37); OR 2.86 ([1.20-6.801; P=0.016). Fracture stability was better achieved with surgery (86.0%, 49/57; 63.6%, 28/44); OR 3.50 ([1.33-9.21], P=0.009).CONCLUSIONS: In general, octogenarians undergoing surgery for OF showed higher fusion and stability rates compared to nonsurgery, which may be due in part to surgical selection criteria, surgeon preference and patient comorbidities. Higher complications were observed for surgery patients, while no differences were observed for mortality. Prospective trials are greatly needed to identify the optional treatment modality and predictors of clinical outcome in octogenarians suffering OF.
机译：简介：牙曲面骨折（of）是老年人最常见的颈椎骨折类型，往往遵循低速下降。预期期望的升高导致八十型患者的痛苦增加，最佳治疗仍未确定。证据收购：通过03/2016对所有文章进行全面搜索（国家医学内容，Cochrane Consection试验中的Cockrane Central Ressions）。如果研究人群评估≥80岁患者的治疗方式，则包括文章。评估结果是死亡率，并发症，骨折和骨折稳定性。报告汇总的差距（或）和95％置信区间（CL）。相似：在22例案例系列/回顾性研究中，占该遗传性的死亡率为5.4％（8/149）与10.1％（10/99） nonsurgery（p = 0.159）。手术患者的并发症率较高（38.9％，58/149; v5。24.5％，26/106）;或1.96（[1.13-3.40]，p = 0.016）。骨质联盟在手术中更好地实现（68.5％，37/54;员长43.2％，16/37）;或2.86（[1.20-6.801; p = 0.016）。手术（86.0％，49/57; 63.6％，28/44）更好地实现骨折稳定性;或3.50（[1.33-9.21]，p = 0.009）。总结：一般来说，与非必要手术相比，逐渐发生的术语，其表现出更高的融合和稳定性率，这可能部分地归因于外科选择标准，外科医生偏好和患者的合并症。手术患者观察到更高的并发症，而死亡率没有观察到差异。绝望试验需要鉴定八十岁患者患者临床结果的可选治疗方式和预测因子。

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