PMID- 21206289
OWN - NLM
STAT- MEDLINE
DCOM- 20111006
LR  - 20161125
IS  - 1529-8809 (Electronic)
IS  - 0022-5282 (Linking)
VI  - 71
IP  - 2
DP  - 2011 Aug
TI  - Survival of atlanto-occipital dissociation correlates with atlanto-occipital 
      distraction, injury severity score, and neurologic status.
PG  - 393-5
LID - 10.1097/TA.0b013e3181eb6a31 [doi]
AB  - BACKGROUND: Case series suggest that atlanto-occipital dissociation (AOD) is a 
      potentially survivable injury. Intuitively, a significant neurologic injury, a 
      high degree of initial distraction, and more severe associated injuries would 
      decrease the likelihood of survival. However, this has never been demonstrated 
      for this injury pattern in a statistically meaningful way. The purpose of this 
      study was to assess the relationship of atlanto-occipital distraction, presence 
      of a complete neurologic injury, and Injury Severity Score (ISS) to the rate of 
      survival in AOD. METHODS: One thousand one hundred seventy-four patients from 
      2005 to 2009 comprehensive trauma database were retrospectively reviewed. 
      Fourteen patients diagnosed with AOD were included in the study. Outcome measures 
      assessed included survival, neurologic status, and ISS. The basion-dens interval 
      (BDI) was measured on the computed tomography scan. Fisher's exact test and 
      Wilcoxon's test were used to evaluate possible associations. RESULTS: Six 
      patients died with complete, high cervical, spinal cord injuries. Follow-up for 
      survivors ranged from 6 months to 2 years. Mortality was associated with the 
      presence of complete neurologic deficit (p = 0.0047), a high basion-dens interval 
      (>16 mm, p = 0.015), and a high ISS (p = 0.0373). CONCLUSIONS: AOD is a 
      potentially survivable injury; however, there may be identifiable subsets of 
      patients where the injury is so severe that treatment is unlikely to change the 
      outcome. This is the first study to show that the ISS and the presence of a 
      complete neurologic injury correlate with nonsurvivability of this devastating 
      injury. A larger case series would help to generalize the results, given the 
      small sample size.
FAU - Chaput, Christopher D
AU  - Chaput CD
AD  - Department of Orthopedic Surgery, Scott and White Memorial Hospital and Clinic, 
      Temple, Texas 76508, USA. cchaput@swmail.sw.org
FAU - Torres, Erick
AU  - Torres E
FAU - Davis, Matthew
AU  - Davis M
FAU - Song, Juhee
AU  - Song J
FAU - Rahm, Mark
AU  - Rahm M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Trauma
JT  - The Journal of trauma
JID - 0376373
SB  - IM
MH  - Atlanto-Occipital Joint/*injuries
MH  - Cervical Vertebrae/injuries
MH  - Humans
MH  - Injury Severity Score
MH  - Joint Dislocations
MH  - Quadriplegia/mortality
MH  - Retrospective Studies
MH  - Spinal Cord Injuries/mortality
MH  - Wounds and Injuries/mortality
EDAT- 2011/01/06 06:00
MHDA- 2011/10/07 06:00
CRDT- 2011/01/06 06:00
PHST- 2011/01/06 06:00 [entrez]
PHST- 2011/01/06 06:00 [pubmed]
PHST- 2011/10/07 06:00 [medline]
AID - 10.1097/TA.0b013e3181eb6a31 [doi]
PST - ppublish
SO  - J Trauma. 2011 Aug;71(2):393-5. doi: 10.1097/TA.0b013e3181eb6a31.