科研之友
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摘要
Background: Dens fractures in elderly patients are often related to issues associated with aging. We examined the association between degenerative changes of the atlanto-dens joint and the risk of dens fracture. %26lt;br%26gt;Methods: We conducted a retrospective study of trauma patients, fifty-five years of age or older, who had undergone a computed tomography scan of the cervical spine as part of their admission to a single level-I trauma center. There were 1794 patients who met the inclusion criteria; scans were evaluated for all fifty-six who presented with a dens fracture and for a random sample of 736 without a dens fracture. Intraosseous cyst formation, synovitis, and joint space narrowing were recorded from the scans. The prevalence of degenerative changes was compared between patients with and patients without a dens fracture. %26lt;br%26gt;Results: An intraosseous cyst in the dens was found in 16.4% of the patients without a dens fracture and in 64.3% of those with a fracture (p %26lt; 0.001). The dens fracture extended through the existing cyst in twenty-four (66.7%) of thirty-six patients with a cyst and a dens fracture. Retro-dens synovitis was present in 4.2% of the patients without a dens fracture and 25.0% of those with a fracture (p %26lt; 0.001). After adjustment for age and sex, both cysts (odds ratio [OR] = 7.7, 95% confidence interval [Cl] = 4.2 to 14.1) and synovitis (OR = 4.6, 95% Cl = 2.1 to 10.0) were significantly associated with dens fracture. %26lt;br%26gt;Conclusions: Intraosseous dens cysts and retro-dens synovitis were associated with dens fracture; those with a dens fracture were nearly eightfold more likely to have an intraosseous cyst and nearly fivefold more likely to have synovitis compared with those without a dens fracture. Because the atlanto-dens joint is a synovial joint, its degeneration can lead to subchondral cyst formation and synovitis and predispose affected individuals to fracture.
- 出版日期2014-5-7
