2013脊髓损伤指南 17.Management_of_Acute_Combination_Fractures_of_the.pdf

CHAPTER 13 TOPIC CHAPTER 13 Management of Acute Combination Fractures of the Atlas and Axis in Adults Timothy C. Ryken, MD, MS* Mark N. Hadley, MD‡ KEY WORDS: Atlas, Axis, Cervical spine trauma, Fracture, Methodology, Practice guidelines Bizhan Aarabi, MD, FRCSC§ Neurosurgery 72:151–158, 2013 DOI: 10.1227/NEU.0b013e318276ee55 Sanjay S. Dhall, MD¶ Daniel E. Gelb, MDk R. John Hurlbert, MD, PhD, RECOMMENDATIONS was undertaken using Medical Subject Headings in FRCSC# combination with “vertebral fracture”: “atlas,” Curtis J. Rozzelle, MD** Level III: “axis,” and “human.” This strategy yielded 202 Nicholas Theodore, MD‡‡ he treatment of combination atlas-axis frac- references. The abstracts were reviewed, and Beverly C. Walters, MD, MSc, tures based primarily on the specific charac- articles focusing on clinical management and FRCSC‡§§ Tteristics of the axis fracture is recommended. follow-up of combination fractures of the atlas • External immobilization of most C1-C2 com- and axis were selected for inclusion. The relative *Iowa Spine Brain Institute, University of bination fractures is recommended. infrequency of these fractures, the small number Iowa, Waterloo/Iowa City, Iowa; ‡Division of • C1-type II odon