A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 1: Mechanism of Injury in 93 patients

Patient Age (yr)

MVA

Fall

Other

16-34

19

2

2

35-49

5

6

3

50-64

6

4

0

65-94

11

33

2

Total

41

45

7

"Other" includes motorcycle accidents

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 2: Initial Neurological Status Related to Degree of Fracture Subluxation

Neurologic Status

Presence/Direction of Fracture Subluxation (no. of patients)

.

None

Anterior

Posterior

Other

Complete SCI

0

0

2

0

Partial SCI

0

3

7

0

No Deficit

32

19

26

1

Uncertain

1

0

2

0

Total

33

22

37

1

"Other" denotes one patient with lateral shift of odontoid peg relative to body of C2
"SCI" denotes spinal cord injury

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 3: Type of External Fixation Device Used Related to Fracture Type (68 patients)

.

No. of Patients with Acute Injuries
No. of Patients with Chronic Injuries

Fixation Device

Type II

Type III

Type II

Type III

Halo Vest

17

12

0

0

Hard Collar

13

6

1

2

Somi Brace

5

6

0

0

Guilford Brace

2

2

0

0

Soft Collar

1

0

0

1

Total

38

26

1

3

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 4: Outcome in Patients with External Fixation Related to Fracture Type

.

Acute Injuries
Subacute/Chronic Injuries

Result

Type II

Type III

Type II

Type III

Union

19

15

0

1

Nonunion

8

3

0

1

Lost to follow-up

7

8

1

1

Dead

4

0

0

0

Total

38

26

1

3

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 5: Comparison of Direction of Subluxation with Treatment Outcome for All Nonsurgical Patients

Result

Ant. Sublux.

Post. Sublux.

No Displ.

Other

Union

12

10

12

0

Non-union

2

6

4

1

Lost to follow-up

5

5

7

0

Dead

1

1

2

0

Total

20

22

25

1

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 6: Comparison of Patient Age with Treatment Outcome for All Nonsurgical Patients

Patient Age (yr)

Union

Nonunion

Lost to follow-up

Dead

16-34

15

3

3

0

35-49

8

1

1

0

50-64

3

1

2

0

65-94

8

8

11

4

Total

34

12

17

4

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 7: Comparison of Fixation Device with Treatment Outcome for All Nonsurgical Patients

Fixation Device

Union

Nonunion

Lost to follow-up

Dead

Halo Brace

19

6

4

0

Other

15

7

13

4

Total

34

13

17

4

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 8: Results of Surgical Fusion in 18 Acute Odontoid Fractures

Outcome

Anterior Screw Fixation

Posterior Cervical Fusion

Union

5

4

Nonunion

-

-

Lost to follow-up

7

1

Dead

1

2

Total

13

7

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention

Table 9: Comparison of Patient Age and Management

.

Fracture Management:

Patient Age (yr)

External Immobilization

Anterior Screw Fixation

Posterior Cervical Fusion

16-34

21

2

0

35-49

10

1

2

50-64

6

2

1

65-94

31

8

4

Total

68

13

7

Back to A Six Year Review of Odontoid Fractures: The Emerging Role of Surgical Intervention