Odontoid Fracture in Geriatric Patients - Analysis of Complications and Outcome Following Conservative Treatment Vs. Ventral and Dorsal Surgery

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2023 Nov 16

PMID 37968595

Authors

Matthias K Jung

Lukas Hornig

Philipp Raisch

Paul A Grutzner

Michael Kreinest

Affiliations

Soon will be listed here.

Abstract

Background: Different treatment options are discussed for geriatric odontoid fracture. The aim of this study was to compare the treatment options for geriatric odontoid fractures.

Methods: Included were patients with the following criteria: age ≥ 65 years, identification of seniors at risk (ISAR score ≥ 2), and odontoid fracture type A/B according to Eysel and Roosen. Three groups were compared: conservative treatment, surgical therapy with ventral screw osteosynthesis or dorsal instrumentation. At a follow-up examination, the range of motion and the trabecular bone fracture healing rate were evaluated. Furthermore, demographic patient data, neurological status, length of stay at the hospital and at the intensive care unit (ICU) as well as the duration of surgery and occurring complications were analyzed.

Results: A total of 72 patients were included and 43 patients could be re-examined (range: 2.7 ± 2.1 months). Patients with dorsal instrumentation had a better rotation. Other directions of motion were not significantly different. The trabecular bone fracture healing rate was 78.6%. The patients with dorsal instrumentation were hospitalized significantly longer; however, their duration at the ICU was shortest. There was no significant difference in complications.

Conclusion: Geriatric patients with odontoid fracture require individual treatment planning. Dorsal instrumentation may offer some advantages.

Citing Articles

Outcome of Conservative Treatment of Odontoid Fractures in Elderly Patients Over 80 Years Old.

Speldova A, Vcelak J, Mirchi L, Sedova L, Seda O Geriatr Orthop Surg Rehabil. 2025; 16:21514593251315589.

PMID: 40078446 PMC: 11898091. DOI: 10.1177/21514593251315589.

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