ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Survival and neurological outcomes after traumatic atlanto-occipital dislocation: a combined multicenter clinical and forensic study.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTraumatic atlanto-occipital dislocation (AOD) is a rare, severe high-energy injury historically associated with near-100% fatality. Improved prehospital care and diagnostics have enhanced survivability, underscoring the need for prompt stabilization without traction to avert secondary spinal cord injury (SCI). This combined clinical-forensic study evaluates modern management, survival, and neurological outcomes in AOD.
methodsRetrospective multicenter review (6 German level I trauma centers, 2007–2023) of 19 AOD cases, plus forensic analysis of 897 road traffic accident (RTA) autopsies (2003–2023) for AOD frequency and mechanisms. Outcomes included mortality, AIS grades (ISNCSCI 2019/2023), and clinical neurological status. Statistics: Welch t-test, chi-square; exploratory (n = 19/92 total, no power).
resultsMean age 41 years (range 9–86). Traynelis types I:3, II:14, III:2. Mean GCS arrival: 6 (3–15). Two patients (10.5%) died preoperatively. Of 17 surgical patients, 5 (29.4%, 95% CI 13.0–52.6%) died postoperatively, yielding overall in-hospital mortality 7/19 (36.8%, 95% CI 19.1–59.0%). Of 12 survivors, 2/12 (16.7%, 95% CI 4.7–44.8%) improved ≥ 1 AIS grade; 10/12 (83.3%, 95% CI 55.2–95.3%) showed clinical neurological improvement per clinicians (e.g., motor gains/vent wean in stable AIS D; AIS insensitive for incompletes—Kirshblum, Spinal Cord 2022). Forensic: AOD in 8.1% RTA fatalities (73/897; 57 no SCI + 16 SCI), brainstem lacerations (65%), aortic injuries (48%) dominant; polytrauma (52%) leading death cause (chi-sq vs. non-AOD p = 0.012). Dens–McGregor distance higher in deaths (10.8 mm SD 5.7 vs. survival 5.8 mm SD 4.1; Welch p = 0.068, power = 0.12).
conclusionsAOD survivorship ~ 63%, with dual metrics revealing 83% clinical improvement post-stabilization (17% AIS shifts). Forensic data (chi-sq link) frame prehospital risks (e.g., traction aligning with brainstem patterns), suggesting time-critical occipitocervical fusion (C0–C2) without traction. Early high-resolution CT pivotal.
Indexed as
Identifiers
41746342What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.