Table 4 Published cases of odontoid fractures associated with cardiac arrest
Author (Year) | Patient | Trauma | Down Time | CPR | ROSC | Fracture | Myelopathy | Myelocompression | Neurological Deficit | Treatment | Return of Consciousness | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Kubokura [29] | 20 y/o female | Car accident | Six minutes | Professional | Yes | Fracture of odontoid process Anterior with atlantoaxial dislocation | Not specified | Not specified | Quadriplegia | Traction by Glisson’s method | Five days | Weaned off the respirator after four months, independent after six months |
Graziano [28] | 62 y/o female | Car accident | Not specified | Professional | Yes | Anderson-d’Alonzo type II odontoid fracture with significant distraction but without significant subluxation | Not specified | Not specified | fixed, dilated pupils, no response to deep pain, absence of brainstem reflexes, including cold caloric stimulation | Cardiorespitatory support | No | full cardiac arrest within 2 h of arrival to hospital, died after unsuccessful CPR |
Powell [32] | 59 y/o male | Domestic collapse of unknown etiology | Not specified | Professional | Yes | Fracture of the odontoid process fracture with 4 mm posterior dislocation | Not specified | Not specified | Apnea, clinical signs consistent with a complete spinal cord injury below C2 | Cardiorespiratory support on ICU | No | Death after three days |
Bowers [10] | 58 y/o female | Domestic fall | None | Bystander CPR and medical reanimation | Yes | Anderson-d’Alonzo type III odontoid fracture; Jefferson-type fracture of the atlas | Yes | No | Apnea, quadriplegia with complete paralysis below the neck | Cardiorespiratory support on ICU | No | Death (unspecified) |
Pérez-Bovet [31] | 68 y/o male | Car accident | None | Professional (in-hospital arrest) | No | Anderson-d’Alonzo type IIA odontoid fracture (base fracture with anterior luxation) | Not specified | Not specified | Initially without deficit | CPR | No | Death during CPR |
Barber Ansón [27] | 67 y/o male | Bike accident | Not specified | Not specified | Yes, after 34 min | Anderson-d’Alonzo type II odontoid fracture | Yes | No | Apnea, quadriplegia with complete paralysis below the neck | Cardiorespiratory support on ICU | No | Death after six days |
Maeda [30] | 62 y/o male | Fall in the street | None | Bystander CPR and medical reanimation | Yes, after 3 min | Anderson-d’Alonzo type II odontoid fracture | Yes | Yes | Difficulty in movement of arms and legs, hypoesthesia (ASIA D) | Posterior fixation of C1-C2 | Yes | Discharge (unspecified) |