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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：齿状突骨折（OF）是老年人最常见的颈椎骨折类型，通常发生在低速跌倒后。随着预期寿命的增加，80多岁的老年人患癌症的人数增加，最佳治疗方案尚未确定。证据获取：对截至2016年3月的所有文章进行了全面搜索（国家医学图书馆MEDLINE，Cochrane中央对照试验登记册）。如果研究人群对老年患者的治疗方式进行评估，则纳入文章≥80年了。评估结果包括死亡率、并发症、骨愈合和骨折稳定性。报告了合并优势比（OR）和95%置信区间（Cl）。证据综合：在22个病例系列/回顾性研究中，手术的归因死亡率为5.4%（8/149），非手术的归因死亡率为10.1%（10/99）（P=0.159）。手术患者并发症发生率较高（38.9%，58/149；V5.24.5%，26/106）；或1.96（[1.13-3.40]，P=0.016）。手术后骨愈合较好（68.5%，37/54；w.43.2%，16/37）；手术后骨折稳定性更好（86.0%，49/57；63.6%，28/44）；或3.50（[1.33-9.21]，P=0.009）。结论：总的来说，与非手术治疗相比，接受OF手术的80岁以上患者显示出更高的融合率和稳定性，部分原因可能是手术选择标准、外科医生偏好和患者共病。手术患者的并发症发生率较高，而死亡率没有差异。我们迫切需要进行前瞻性试验，以确定患有癌症的80岁患者的可选治疗方式和临床结果的预测因素。

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