SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
The optimal treatment of type II and III odontoid fractures in the elderly: an updated meta-analysis.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Matched case-control study of odontoid osteosynthesis vs hard collar immobilisation for Type II odontoid fractures in the elderly: higher risk of adverse events with no long-term functional benefits.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Salvage Posterior C1-C2 Fusion for Odontoid Nonunion After Failed Nonoperative Management: A Propensity Score-Matched Comparison with Primary Fusion.Journal of clinical medicine · 2026Article
- Cervical Collar in Adult Trauma: Evidence, Controversies, and Clinical Decision-Making.Orthopedic research and reviews · 2026Review
- Anterior Odontoid Screw Fixation for Trauma: Case Series and Technical Considerations.Journal of clinical medicine · 2025Article
- Ununited Mobile Odontoid Fracture: Clinical and Imaging Findings With Subsequent Management: A Case Report.Journal of chiropractic medicine · 2025Article
- Outcome of Conservative Treatment of Odontoid Fractures in Elderly Patients Over 80 Years Old.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Odontoid Fractures: A Review of the Current State of the Art.Journal of clinical medicine · 2024Review
- Surgical versus conservative treatment for odontoid fractures in older people: an international prospective comparative study.Age and ageing · 2024Article
- Risk Factors of Nonunion After Anterior Screw Fixation of Anderson and D'Alonzo Type II Odontoid Fractures.In vivo (Athens, Greece)Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOdontoid fractures are the most common cervical spine fractures in the elderly, with a controversial optimal treatment. The objective of this review was to compare the outcome of surgical and conservative treatments in elderly (≥ 65 years), by updating a systematic review published by the authors in 2013.
methodsA comprehensive search was conducted in seven databases. Clinical outcome was the primary outcome. Fracture union- and stability were secondary outcomes. Pooled point estimates and their respective 95% confidence intervals (CIs) were derived using the random-effects model. A random-effects multivariable meta-regression model was used to correct for baseline co-variates when sufficiently reported.
resultsForty-one studies met the inclusion criteria, of which forty were case series and one a cohort study. No clinical differences in outcomes including the Neck Disability Index (NDI, 700 patients), Visual Analogue Scale pain (VAS, 180 patients), and Smiley-Webster Scale (SWS, 231 patients) scores were identified between surgical and conservative treatments. However, fracture union was higher in surgically treated patients (pooled incidence 72.7%, 95% CI 66.1%, 78.5%, 31 studies, 988 patients) than in conservatively treated patients (40.2%, 95% CI 32.0%, 49.0%, 22 studies, 912 patients). This difference remained after correcting for age and fracture type. Fracture stability (41 studies, 1917 patients), although numerically favoring surgery, did not appear to differ between treatment groups.
conclusionWhile surgically treated patients showed higher union rates than conservatively treated patients, no clinically relevant differences were observed in NDI, VAS pain, and SWS scores and stability rates. These results need to be further confirmed in well-designed comparative studies with proper adjustment for confounding, such as age, fracture characteristics, and osteoporosis degree.
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