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. 2017:2017:6516893.
doi: 10.1155/2017/6516893. Epub 2017 Oct 17.

Epidemiology of C2 Fractures in the 21st Century: A National Registry Cohort Study of 6,370 Patients from 1997 to 2014

Anna-Lena Robinson  1   2 , Claes Olerud  2 , Yohan Robinson  2
Affiliations

Epidemiology of C2 Fractures in the 21st Century: A National Registry Cohort Study of 6,370 Patients from 1997 to 2014

Anna-Lena Robinson et al. Adv Orthop. 2017.

Abstract

Objective: C2 fractures are a common injury in the elderly population. Treatment is often complicated due to osteoporosis and patient comorbidity. This study aims to investigate the incidence and treatment trend of C2 fractures in Sweden.

Methods: Patients with the principal and secondary diagnosis of fracture of the second vertebrae (ICD-10: S12.1) between 1997 and 2014 were identified in the Swedish National Patient Registry (NPR).

Results: Between 1997 and 2014, 6,370 patients with a C2 fracture (51% male; age: 72 ± 18) were identified in the NPR. The incidence of C2 fractures increased from 3 to 6 per 100,000 (r = 0.94; p < 0.01), mainly due to an increase of incidence in the geriatric subgroup (≥70 years). The percentage of surgically treated patients decreased from 1997 to 2014 (r = -0.80; p < 0.01). Younger age, male gender, spinal cord injury, and earlier year of admission were associated with surgical treatment assignment.

Discussion: This study documents a rising incidence of C2 fractures in the elderly during the last two decades in Sweden. Greater awareness of fractures, improved diagnostics, coding, and a higher activity level of the patients are plausible causes. The declining trend of surgical treatment warrants further study.

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Figures

Figure 1
Figure 1
Inclusion flow diagram.
Figure 2
Figure 2
C2 fracture incidence per 100,000 of nongeriatric (blue) and geriatric (red) patients between 1997 and 2014.
Figure 3
Figure 3
Age distribution of C2 fractures.
Figure 4
Figure 4
Incidence of C2 fractures between 1997 and 2014 per 100,000 in geriatric age categories: 70–79 years (blue), 80–89 years (orange), and 90–99 years (grey).
Figure 5
Figure 5
Empirical age distribution for C2 fractures with and without surgical treatment.
Figure 6
Figure 6
Annual proportion of surgically treated patients with C2 fractures.
Figure 7
Figure 7
Proportion of surgically treated nongeriatric (blue) and geriatric (orange) patients with C2 fractures between 1997 and 2014.
See this image and copyright information in PMC

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