Format

Send to

Choose Destination
Neurosurgery. 2015 Oct;77 Suppl 4:S6-14. doi: 10.1227/NEU.0000000000000942.

A Systematic Review of the Treatment of Geriatric Type II Odontoid Fractures.

Author information

1
*Rothman Institute at Thomas Jefferson University, Department of Orthopedic Surgery, Philadelphia, Pennsylvania; ‡Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania; §Department of Orthopedic Surgery, University of Utah, Salt Lake City, Utah; ¶Swedish Neuroscience Institute, Department of Orthopedic Surgery, Seattle, Washington.

Abstract

BACKGROUND:

Odontoid fractures are the most common cervical spine fracture in the geriatric population; however, the treatment of type II odontoid fractures in this age group is controversial.

OBJECTIVE:

To compare the short-term (<3 months) mortality, long-term (≥12 months) mortality, and complication rates of patients >60 years of age with a type II odontoid fracture managed either operatively or nonoperatively.

METHODS:

We performed a systematic review of literature published between January 1, 2000, and February 1, 2015, related to the treatment of type II odontoid fractures in patients >60 years of age. An analysis of short-term mortality, long-term mortality, and the occurrence of complications was performed.

RESULTS:

A total of 452 articles were identified, of which 21 articles with 1233 patients met the inclusion criteria. Short-term mortality (odds ratio, 0.43; 95% confidence interval, 0.30-0.63) and long-term mortality (odds ratio, 0.47; 95% confidence interval, 0.34-0.64) were lower in patients who underwent surgical treatment than in those who had nonsurgical treatment, and there were no significant differences in the rate of complications (odds ratio, 1.01; 95% confidence interval, 0.63-1.63). Surgical approach (posterior vs anterior) showed no significant difference in mortality or complication rate. Similarly, no difference in mortality or complication rate was identified with hard collar or a halo orthosis immobilization.

CONCLUSION:

The current literature suggests that well-selected patients >60 years of age undergoing surgical treatment for a type II odontoid fracture have a decreased risk of short-term and long-term mortality without an increase in the risk of complications.

PMID:
26378359
DOI:
10.1227/NEU.0000000000000942
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center