$type 2 odontoid fracture icd 10$

$type 2 odontoid fracture icd 10$

Type 2 odontoid fracture icd 10 trial#

Patient comorbidity could be another explanation for physicians’ tendency to use a cervical collar in the belief that this will avoid further damage. There is a trend towards non-surgical treatment in Sweden the fear of overtreatment could be a contributing factor. Despite the fatal implications of inaccurate treatment, the most recent treatment recommendations vary widely, while surgeon adherence is highly dependent on regional differences. Some earlier non-randomised studies have shown no significant difference between surgical treatment or non-surgical treatment regarding functional outcome (NDI, Neck Disability Index) or functional outcome score), pain and patient satisfaction the AOSpine North America Geriatric Odontoid Fracture (GOF) study has found significantly better outcomes measuring the NDI and the SF-36 Bodily Pain dimension comparing non-surgically and surgically treated patients. The treatment of displaced type-2 odontoid fractures in the elderly varies from external orthosis treatment with a rigid collar to surgery, including anterior screw osteosynthesis and posterior C1–C2 fusion. The mortality of odontoid fractures, meanwhile, is strongly related to age, gender, comorbidity and type of treatment. As with other osseous injuries in the elderly, the occurrence of odontoid fractures has been related to fragility, osteoporosis and falls. The most common upper cervical fracture in elderly people aged ≥ 70 years is the type-2 odontoid fracture, with an incidence of 15.6 per 100,000 person-years in 2014.

$type 2 odontoid fracture icd 10$

Unstable injuries to the upper cervical spine are a hazard to every elderly person, since associated dysphagia and respiratory restrictions are potential deadly complications. Registered retrospectively on 25 August 2015. Major limitations are (1) the allocation bias of the open-label study design, (2) that only higher training levels of all core specialties of spine surgery are included in the surgical treatment arm and (3) that only one type of surgical stabilisation is investigated (posterior C1–C2 fusion), while other methods are not included in this study. Using the NDI and EQ-5D as endpoints, future value-based decisions may consider quality-adjusted life years gained.

Type 2 odontoid fracture icd 10 trial#

USOFT is the first randomised controlled trial comparing non-surgical and surgical management of type-2 odontoid fractures in the elderly. The secondary endpoints are: EQ-5D score, activities of daily living (ADL), bony union, upper cervical stability and mortality. At 12 months, a dynamic radiographical investigation of upper cervical stability is performed. All participants are monitored with regard to the NDI, EuroQol score (EQ-5D), socio-demographics and computed tomography (CT) at the time of injury, at 6 weeks, 3 months and 12 months. The surgical group is treated with a posterior C1–C2 fusion. The non-surgical group is fitted with a rigid cervical collar for 12 weeks. By considering a 1-year mortality forecast of 29%, up to 25 participants are recruited in each group. A minimum of 16 patients are needed in each group to test the superiority with 80% power. The minimal clinically important difference of the NDI is 3.5 points. Excluded are patients with an American Society of Anaesthesiologists (ASA) score ≥ 4, dementia nursing care or anatomical cervical anomalies. Fifty consecutive patients aged ≥ 75 years, with displaced type-2 odontoid fracture, are randomised to non-surgical or surgical treatment. The Uppsala Study on Odontoid Fracture Treatment (USOFT) is a multicentre, open-label, randomised controlled superiority trial evaluating the clinical superiority of the surgical treatment of type-2 odontoid fractures, with a 1-year Neck Disability Index (NDI) as the primary endpoint.

$type 2 odontoid fracture icd 10$

Due to the paucity of evidence, the treatment decision is often left to the discretion of the expert surgeon. Displaced odontoid fractures in the elderly are treated non-surgically with a cervical collar or surgically with C1–C2 fusion.

$type 2 odontoid fracture icd 10$