目的:本研究旨在研究OCF的作用机制,他们的临床症状,计算机断层扫描(CT)扫描结果,治疗方案,和分类。
方法:对2017年至2023年在我们神经外科中心住院的43例OCF患者进行了回顾性分析。
结果:调查涵盖了他们的临床症状,CT扫描结果,和治疗结果。结果发现,25.6%的患者患有严重颅脑损伤,格拉斯哥昏迷量表(GCS)评分为3-8分,9.3%的人中度受伤,GCS评分为9-12分,65.1%表现为轻度损伤,GCS评分为13-15分。在这些病人中,90.7%出院后有所改善,4.7%的人死于伤病,另有4.7%的人出现截瘫。CCJ损伤患者OCF的症状包括颈部疼痛,肿胀,颅神经麻痹,咽后壁肿胀。OCF患者经常观察到的并发症包括脑挫裂伤,枕骨骨折,颅底骨折.采用CCJ区域的薄层CT扫描,随着矢状和冠状CT重建,对于识别OCF至关重要。根据Anderson-Montesano分类将骨折分为三种类型,which,修改时,提供增强的治疗指导。
结论:OCF主要存在于高能创伤病例中,高分辨率薄层CT扫描作为首选的诊断方法。修改后的Anderson-Montesano分类法的应用,区分稳定和不稳定的骨折,有助于确定合适的治疗策略。稳定的OCF可以使用刚性颈托进行管理,而不稳定的OCF可能需要Halo-vest框架固定或手术干预。
This
study aimed to examine the mechanism of occipital condyle fractures (OCFs), their clinical symptoms, computer tomography (CT) scan findings, treatment options, and classification.
A retrospective analysis was conducted on 43 patients with OCFs who were admitted to our neurosurgery center between 2017 and 2023.
The investigation covered their clinical symptoms, CT scan results, and treatment outcomes. It was found that 25.6% of the patients suffered from severe craniocerebral injuries with Glasgow Coma Scale (GCS) scores of 3-8 points, 9.3% had moderate injuries with GCS scores of 9-12 points, and 65.1% exhibited mild injuries with GCS scores of 13-15 points. Of these patients, 90.7% showed improvement upon discharge, 4.7% succumbed to their injuries, and another 4.7% developed paraplegia. Symptoms indicative of OCF in individuals with CCJ injuries included neck pain, swelling, cranial nerve palsy, and posterior pharyngeal wall swelling. Frequently observed complications in OCF patients included cerebral contusion, occipital bone fractures, and skull base fractures. Employing thin-layer CT scans of the CCJ area, along with sagittal and coronal CT reconstructions, is essential for identifying OCFs. The fractures were classified into 3 types based on the Anderson-Montesano classification, which, when modified, provides enhanced treatment guidance.
OCFs are predominantly present in cases of high-energy trauma, with high-resolution thin-layer CT scans serving as the preferred diagnostic method. The application of the modified Anderson-Montesano classification, distinguishing between stable and unstable fractures, facilitates the determination of suitable treatment strategies. Stable OCFs can be managed using a rigid neck brace, while unstable OCFs may require Halo-vest frame fixation or surgical intervention.