Surgical versus conservative management for odontoid fractures

Cost Effectiveness of Operative Versus Non-Operative Treatment of Geriatric Type-II Odontoid Fracture

“…Based on the results of this study, operative treatment is likely cost effective for patients aged 65–84, while for patients older than 84, operative treatment is probably more costly and less effective. This study, like the Cochrane Review by Shears et al, 7 echoes the need for a well-conducted randomized controlled trial to determine the optimal treatment for type-II odontoid fractures in geriatric patients. Such a study would be challenging to perform given the likely difficulty of enrolling patients and the fact that many surgeons feel there is already a lack of equipoise on the topic.…”

Cost Effectiveness of Operative Versus Non-Operative Treatment of Geriatric Type-II Odontoid Fracture

“…Based on the results of this study, operative treatment is likely cost effective for patients aged 65–84, while for patients older than 84, operative treatment is probably more costly and less effective. This study, like the Cochrane Review by Shears et al, 7 echoes the need for a well-conducted randomized controlled trial to determine the optimal treatment for type-II odontoid fractures in geriatric patients. Such a study would be challenging to perform given the likely difficulty of enrolling patients and the fact that many surgeons feel there is already a lack of equipoise on the topic.…”

Type II Odontoid Fracture in a Nonagenarian

“…[5][6][7] As reported in a Cochrane review, the lack of prospective data for odontoid fractures has prohibited any meaningful comparison between surgery and nonoperative treatment as the preferred treatment modality. 8 This is in sharp contrast to the volume and quality of reviews and trials available for femoral neck fractures despite a similar increase in incidence in the aging population.…”

T‐locking compression plate fixation of a cranial mid‐body axis fracture in an adult horse

“…Treatment of odontoid fractures aims to re‐establish anatomical alignment and provide adequate stabilisation of the fracture to enable bone healing. In human medicine, both conservative and surgical management are common for all three fracture types (Shears & Armitstead, 2008). Conservative management of odontoid fractures includes the application of a cervical collar (with or without prior traction) and the use of an external fixation device (Halo device).…”

“…Conservative management of odontoid fractures includes the application of a cervical collar (with or without prior traction) and the use of an external fixation device (Halo device). Surgical approaches to odontoid fractures include posterior C1–C2 fusion techniques and anterior screw fixation of the odontoid process itself (Shears & Armitstead, 2008). For type 3 fractures, the use of a cervical collar alone has been shown to yield fusion rates of 50%–60%, whereas fusion rates of 100% were achieved with screw fixation of the odontoid process (Shears & Armitstead, 2008).…”

“…Surgical approaches to odontoid fractures include posterior C1–C2 fusion techniques and anterior screw fixation of the odontoid process itself (Shears & Armitstead, 2008). For type 3 fractures, the use of a cervical collar alone has been shown to yield fusion rates of 50%–60%, whereas fusion rates of 100% were achieved with screw fixation of the odontoid process (Shears & Armitstead, 2008). Conservative management is only advised for nondisplaced or minimally displaced odontoid fractures (displacement inferior to 4 mm).…”

Cost Effectiveness of Operative Versus Non-Operative Treatment of Geriatric Type-II Odontoid Fracture

“…Based on the results of this study, operative treatment is likely cost effective for patients aged 65–84, while for patients older than 84, operative treatment is probably more costly and less effective. This study, like the Cochrane Review by Shears et al, 7 echoes the need for a well-conducted randomized controlled trial to determine the optimal treatment for type-II odontoid fractures in geriatric patients. Such a study would be challenging to perform given the likely difficulty of enrolling patients and the fact that many surgeons feel there is already a lack of equipoise on the topic.…”

Type II Odontoid Fracture in a Nonagenarian

“…[5][6][7] As reported in a Cochrane review, the lack of prospective data for odontoid fractures has prohibited any meaningful comparison between surgery and nonoperative treatment as the preferred treatment modality. 8 This is in sharp contrast to the volume and quality of reviews and trials available for femoral neck fractures despite a similar increase in incidence in the aging population.…”

T‐locking compression plate fixation of a cranial mid‐body axis fracture in an adult horse

“…Treatment of odontoid fractures aims to re‐establish anatomical alignment and provide adequate stabilisation of the fracture to enable bone healing. In human medicine, both conservative and surgical management are common for all three fracture types (Shears & Armitstead, 2008). Conservative management of odontoid fractures includes the application of a cervical collar (with or without prior traction) and the use of an external fixation device (Halo device).…”

“…Conservative management of odontoid fractures includes the application of a cervical collar (with or without prior traction) and the use of an external fixation device (Halo device). Surgical approaches to odontoid fractures include posterior C1–C2 fusion techniques and anterior screw fixation of the odontoid process itself (Shears & Armitstead, 2008). For type 3 fractures, the use of a cervical collar alone has been shown to yield fusion rates of 50%–60%, whereas fusion rates of 100% were achieved with screw fixation of the odontoid process (Shears & Armitstead, 2008).…”

“…Surgical approaches to odontoid fractures include posterior C1–C2 fusion techniques and anterior screw fixation of the odontoid process itself (Shears & Armitstead, 2008). For type 3 fractures, the use of a cervical collar alone has been shown to yield fusion rates of 50%–60%, whereas fusion rates of 100% were achieved with screw fixation of the odontoid process (Shears & Armitstead, 2008). Conservative management is only advised for nondisplaced or minimally displaced odontoid fractures (displacement inferior to 4 mm).…”

Cost Effectiveness of Operative Versus Non-Operative Treatment of Geriatric Type-II Odontoid Fracture

“…Based on the results of this study, operative treatment is likely cost effective for patients aged 65–84, while for patients older than 84, operative treatment is probably more costly and less effective. This study, like the Cochrane Review by Shears et al, 7 echoes the need for a well-conducted randomized controlled trial to determine the optimal treatment for type-II odontoid fractures in geriatric patients. Such a study would be challenging to perform given the likely difficulty of enrolling patients and the fact that many surgeons feel there is already a lack of equipoise on the topic.…”

Type II Odontoid Fracture in a Nonagenarian

“…[5][6][7] As reported in a Cochrane review, the lack of prospective data for odontoid fractures has prohibited any meaningful comparison between surgery and nonoperative treatment as the preferred treatment modality. 8 This is in sharp contrast to the volume and quality of reviews and trials available for femoral neck fractures despite a similar increase in incidence in the aging population.…”

T‐locking compression plate fixation of a cranial mid‐body axis fracture in an adult horse

“…Treatment of odontoid fractures aims to re‐establish anatomical alignment and provide adequate stabilisation of the fracture to enable bone healing. In human medicine, both conservative and surgical management are common for all three fracture types (Shears & Armitstead, 2008). Conservative management of odontoid fractures includes the application of a cervical collar (with or without prior traction) and the use of an external fixation device (Halo device).…”

“…Conservative management of odontoid fractures includes the application of a cervical collar (with or without prior traction) and the use of an external fixation device (Halo device). Surgical approaches to odontoid fractures include posterior C1–C2 fusion techniques and anterior screw fixation of the odontoid process itself (Shears & Armitstead, 2008). For type 3 fractures, the use of a cervical collar alone has been shown to yield fusion rates of 50%–60%, whereas fusion rates of 100% were achieved with screw fixation of the odontoid process (Shears & Armitstead, 2008).…”

“…Surgical approaches to odontoid fractures include posterior C1–C2 fusion techniques and anterior screw fixation of the odontoid process itself (Shears & Armitstead, 2008). For type 3 fractures, the use of a cervical collar alone has been shown to yield fusion rates of 50%–60%, whereas fusion rates of 100% were achieved with screw fixation of the odontoid process (Shears & Armitstead, 2008). Conservative management is only advised for nondisplaced or minimally displaced odontoid fractures (displacement inferior to 4 mm).…”