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Epidemiology

The C2 fracture accounts for nearly 19% of all spinal fractures ^[1] and 55% of cervical fractures. Within C2 fractures, the hangman’s fracture accounts for 23% of occurrences while the Odontoid or dens fracture accounts for 55% of them. ^[2]

Common Causes and High Risk Groups

The pie chart shows the incidence of C2 fractures according to age groups. For the <17 age group, there were 203 incidents. For Age 18-44 there were 1843. For 45-64 there were 2147. For 65-84 there were 4890 and for 85+ there were 3440 incidents. A total of 12,532 discharges in America were reported in 2010.

The injury mainly occurs from falls usually in older adults and motor accidents mainly due to impacts of high force causing extension of the neck and great axial load onto the C2 vertebrae. ^[3]. In a study based in Norway, 60% of reported cervical fractures came from falls and 21% from motor related accidents^[4]. According to the Agency for Healthcare Research and Quality (AHRQ), the group under the highest risk of C2 fractures are elderly people within the age group of 65-84(39.02%) at risks of falls (61%) or motor accidents (21%) in metropolitan areas(94%). 203 discharges were from the age group 1-17; 1843 from 18-44 year olds; 2147 from 45-64 year olds, 4890 from 65-84 year olds, and 3440 from 85+ year olds. Females accounted for 54.45% of occurrences while males accounted for the other 45.38%.

Hospital Costs

The graph shows the trend of hospital charges and # of discharges over the span of 12 years in the U.S.A. In 1998, hospital costs were $24,423 with 4,991 discharged. In 2010 hospital charges increased to 59,939 with 12,532 discharged.

Statistics from the AHRQ show that there were 12,532 hospital discharges from C2 fractures in the US during 2010. The mean healthcare costs were $17,015 and the “national bill” or the aggregate charges were $749,553,403. Only 460 in-hospital deaths related to the C2 fracture occurred. From 2000 to 2010, the number of discharges has increased from 4,875 to 12,532, almost a 250% increase. Mean health care costs went from $24,771 to $59,939.

References

^ Mulligan, RP.; Friedman, JA.; Mahabir, RC. (Mar 2010). "A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures". J Trauma. 68 (3): 587–92. doi:10.1097/TA.0b013e3181b16bc5. PMID 19996802.{{cite journal}}: CS1 maint: date and year (link)
^ Ryan, MD.; Henderson, JJ. (1992). "The epidemiology of fractures and fracture-dislocations of the cervical spine". Injury. 23 (1): 38–40. doi:10.1016/0020-1383(92)90123-a. PMID 1541497.
^ Ryan, MD.; Henderson, JJ. (1992). "The epidemiology of fractures and fracture-dislocations of the cervical spine". Injury. 23 (1): 38–40. doi:10.1016/0020-1383(92)90123-a. PMID 1541497.
^ Pratt, H.; Davies, E.; King, L. (2008). "Traumatic injuries of the c1/c2 complex: computed tomographic imaging appearances". Curr Probl Diagn Radiol. 37 (1): 26–38. doi:10.1067/j.cpradiol.2007.07.001. PMID 18054664.

[1] Mulligan, RP.; Friedman, JA.; Mahabir, RC. (Mar 2010). "A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures". J Trauma. 68 (3): 587–92. doi:10.1097/TA.0b013e3181b16bc5. PMID 19996802.{{cite journal}}: CS1 maint: date and year (link)

[2] Ryan, MD.; Henderson, JJ. (1992). "The epidemiology of fractures and fracture-dislocations of the cervical spine". Injury. 23 (1): 38–40. doi:10.1016/0020-1383(92)90123-a. PMID 1541497.

[3] Ryan, MD.; Henderson, JJ. (1992). "The epidemiology of fractures and fracture-dislocations of the cervical spine". Injury. 23 (1): 38–40. doi:10.1016/0020-1383(92)90123-a. PMID 1541497.

[4] Pratt, H.; Davies, E.; King, L. (2008). "Traumatic injuries of the c1/c2 complex: computed tomographic imaging appearances". Curr Probl Diagn Radiol. 37 (1): 26–38. doi:10.1067/j.cpradiol.2007.07.001. PMID 18054664.

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