Evidence and Controversies in Geriatric Odontoid Fracture Management.
Journal
The Journal of the American Academy of Orthopaedic Surgeons
ISSN: 1940-5480
Titre abrégé: J Am Acad Orthop Surg
Pays: United States
ID NLM: 9417468
Informations de publication
Date de publication:
03 Oct 2023
03 Oct 2023
Historique:
received:
06
05
2023
accepted:
26
08
2023
medline:
4
10
2023
pubmed:
4
10
2023
entrez:
4
10
2023
Statut:
aheadofprint
Résumé
Geriatric odontoid fractures are some of the most common spine injuries in our aging population, and their prevalence is only continuing to increase. Despite several investigational studies, treatment remains controversial and there is limited conclusive evidence regarding the management of odontoid fractures. These injuries typically occur in medically complex and frail geriatric patients with poor bone quality, making their treatment particularly challenging. In this article, we review the evidence for conservative management as well as surgical intervention and discuss various treatment strategies. Given the high morbidity and mortality associated with odontoid fractures in the elderly, thoughtful consideration and an emphasis on patient-centered goals of treatment are critical to maximize function in this vulnerable population.
Identifiants
pubmed: 37793151
doi: 10.5435/JAAOS-D-23-00389
pii: 00124635-990000000-00813
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 by the American Academy of Orthopaedic Surgeons.
Références
Fehlings MG, Tetreault L, Nater A The aging of the Global population: The changing Epidemiology of disease and spinal Disorders. Neurosurgery 2015;77:S1-S5.
Daniels AH, Arthur M, Esmende SM, Vigneswaran H, Palumbo MA: Incidence and cost of treating axis fractures in the United States from 2000 to 2010. Spine 2014;39:1498-1505.
Alluri R, Bouz G, Solaru S, Kang H, Wang J, Hah RJ: A Nationwide analysis of geriatric odontoid fracture incidence, complications, mortality, and cost. Spine 2021;46:131-137.
Zapletal J, Hekster RE, Straver JS, Wilmink JT: - osteoarthritis. Appearance and prevalence at computed tomography. Spine 1995;20:49-53.
Fehlings MG, Arun R, Vaccaro AR, Arnold PM, Chapman JR, Kopjar B: Predictors of treatment outcomes in geriatric patients with fractures: AOSpine North America multi-centre prospective GOF study. Spine 2013;38:881-886.
Chapman J, Smith JS, Kopjar B The AOSpine North America geriatric odontoid fracture mortality study: A retrospective review of mortality outcomes for operative versus nonoperative treatment of 322 patients with long-term follow-up. Spine 2013;38:1098-1104.
Clark CR, White AA 3rd: Fractures of the dens. A multicenter study. J Bone Jointt Surg 1985;67:1340-1348.
Tashjian RZ, Majercik S, Biffl WL, Palumbo MA, Cioffi WG: Halo-vest immobilization increases early morbidity and mortality in elderly fractures. J Trauma Inj Infect Crit Care 2006;60:199-203.
Majercik S, Tashjian RZ, Biffl WL, Harrington DT, Cioffi WG: Halo vest immobilization in the elderly: A death sentence?. J Trauma Inj Infect Crit Care 2005;59:350-357.
Anderson LD, Dʼalonzo RT: Fractures of the process of the axis. J Bone Joint Surg 1974;56:1663-1674.
Ryken TC, Hadley MN, Aarabi BManagement of isolated fractures of the axis in adults. Neurosurgery 2013;72:132-150.
Rizvi SAM, Helseth E, Harr ME, et al.: Management and long-term outcome of type II acute fractures: A population-based consecutive series of 282 patients. Spine J 2021;21:627-637.
Vaccaro AR, Kepler CK, Kopjar B Functional and quality-of-life outcomes in geriatric patients with type-II dens fracture. J Bone Joint Surg 2013;95:729-735.
Smith JS, Kepler CK, Kopjar B Effect of type II fracture nonunion on outcome among elderly patients treated without surgery: Based on the AO Spine North America geriatric fracture study. Spine 2013;38:2240-2246.
Lukins T, Nguyen L, Hansen MA, Ferch RD: Identifying factors influencing mortality in patients aged over 65 following an acute type II process fracture. A retrospective cohort study. Eur Spine J 2021;30:1551-1555.
Sarode DP, Demetriades AK: Surgical versus nonsurgical management for type II fractures in the elderly population: A systematic review. Spine J 2018;18:1921-1933.
Pommier B, Ollier E, Pelletier JB, Castel X, Vassal F, Tetard MC: Conservative versus surgical treatment for odontoid fracture: Is the surgical treatment Harmful? Systematic review and meta-analysis. World Neurosurg 2020;141:490-499.e2.
Dhall SS, Yue JK, Winkler EA, Mummaneni PV, Manley GT, Tarapore PE: Morbidity and mortality associated with surgery of traumatic C2 fractures in octogenarians. Neurosurgery 2017;80:854-862.
Kepler CK, Vaccaro AR, Dibra F Neurologic injury because of trauma after type II nonunion. Spine J 2014;14:903-908.
Lofrese G, Musio A, De Iure F Type II fracture in elderly patients treated conservatively: Is fracture healing the goal?. Eur Spine J 2019;28:1064-1071.
McIlroy S, Lam J, Khan MF Conservative management of type II odontoid fractures in older People: A retrospective Observational comparison of osseous union versus nonunion. Neurosurgery 2020;87:E648-E654.
Sime D, Pitt V, Pattuwage L, Tee J, Liew S, Gruen R: Non-surgical interventions for the management of type 2 dens fractures: A systematic review. ANZ J Surg 2014;84:320-325.
Peck GE, Shipway DJH, Tsang K, Fertleman M: Cervical spine immobilisation in the elderly: A literature review. Br J Neurosurg 2018;32:286-290.
Coleman N, Chan HYH, Gibbons V, Baker JF: Comparison of hard and soft cervical collars for the management of odontoid Peg fractures in the elderly. Geriatr Orthop Surg Rehabil 2022;13:e2110702.
Gembruch O, Lemonas E, Ahmadipour Y Treatment of odontoid type II fractures in octogenarians: Balancing two different treatment Strategies. Neurospine 2019;16:360-367.
Lennarson PJ, Mostafavi H, Traynelis VC, Walters BC: Management of type II dens fractures: A case-control study. Spine 2000;25:1234-1237.
Leister I, Haider T, Vogel M A predictive model to identify treatment-related risk factors for odontoid fracture nonunion using machine learning. Spine 2023;48:164-171.
Schoenfeld AJ, Bono CM, Reichmann WM Type II fractures of the cervical spine: Do treatment type and medical comorbidities affect mortality in elderly patients?. Spine 2011;36:879-885.
Fan L, Ou D, Huang X Surgery vs conservative treatment for type II and III fractures in a geriatric population: A meta-analysis. Medicine (Baltimore) 2019;98:e10281.
von Glinski A, Frieler S, Elia CRisk factors associated with 90-day readmissions following odontoid fractures: A Nationwide readmissions Database study. Spine 2021;46:1039-1047.
Elliott RE, Tanweer O, Boah A Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rod constructs: meta-analysis and review of literature. J Spinal Disord Tech 2014;27:11-28.
Chang MC, Seok HG, Choo YJ, Lee GW: The comparison between transarticular screw fixation and segmental screw-rod fixation for posterior fusion of the C1-2 segment: A systematic review and meta-analysis. World Neurosurg 2022;164:e1007-e1014.
Dailey AT, Hart D, Finn MA, Schmidt MH, Apfelbaum RI: Anterior fixation of fractures in an elderly population. J Neurosurg Spine 2010;12:1-8.
De Bonis P, Iaccarino C, Musio A Functional outcome of elderly patients treated for odontoid fracture: A multicenter study. Spine 2019;44:951-958.
Ricciardi L, Trungu S, Scerrati A screw placement for Anderson type II fractures: How do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study. J Neurosurg Spine 2021;34:27-31.
Shousha M, Alhashash M, Allouch H, Boehm H: Surgical treatment of type II odontoid fractures in elderly patients: a comparison of anterior odontoid screw fixation and posterior atlantoaxial fusion using the Magerl-Gallie technique. Eur Spine J 2019: doi:10.1007/s00586-019-05946-x.
Patterson JT, Theologis AA, Sing D, Tay B: Anterior versus posterior approaches for odontoid fracture stabilization in patients older than 65 Years: 30-day morbidity and mortality in a national Database. Clin Spine Surg A Spine Publ 2017;30:E1033-E1038.
Graffeo CS, Perry A, Puffer RC Deadly falls: Operative versus nonoperative management of type II process fracture in octogenarians. J Neurosurg Spine 2017;26:4-9.
Robinson AL, Olerud C, Robinson Y: Surgical treatment improves survival of elderly with axis fracture-a national population-based multiregistry cohort study. Spine J 2018;18:1853-1860.
Smith S, Somogyi R, Lin C, Yoo JU: Surgical management of type II displaced dens fractures improves one-year mortality in elderly patients. Spine 2022;47:1157-1164.