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

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

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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

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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

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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

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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

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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

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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

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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

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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

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