Operative Treatment of Unstable Odontoid Fractures in the Geriatric Population

Background: Odontoid fractures, often in combination with C1 fractures, are a common fracture of the cervical spine in geriatric patients. The optimal treatment of this fracture in this patient population is often controversial. We report the surgical outcome of unstable type II odontoid fractures in the elderly. Method: 8 patients (median age, 80.5 years; range, 72-93) with unstable type II odontoid fractures according to the Anderson and d'Alonzo classification were included in this prospective study. 2 patients sustained a C1 fracture (1 had an unstable type III fracture according to the Gehweiler classification, and 1 had a stable type III fracture). There were no neurological complications. All patients were classified as ASA class III. 7 patients were treated with anterior odontoid double-screw compression osteosynthesis followed by a firm neck support for 6 weeks. 1 patient with an unstable C1 and C2 fracture was treated with an occipital cervical (C2) fusion in combination with a C1-C2 fusion acco...