ArticleAge and ageing2024
Surgical versus conservative treatment for odontoid fractures in older people: an international prospective comparative study.
Article in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Determining the optimal management of geriatric type II odontoid fractures: a comparative network meta-analysis.Neurosurgical review · 2026Pooled it
- Surgical versus conservative treatment of odontoid fractures in the elderly: A randomized controlled clinical study (SCORE).PloS one · 2025Trial
- 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
- Management of dens fractures in older people and the role of the geriatrician: a survey of practice in UK and Ireland major trauma centres.European geriatric medicine · 2026Article
- Cervical Collar in Adult Trauma: Evidence, Controversies, and Clinical Decision-Making.Orthopedic research and reviews · 2026Review
- Anterior Odontoid Screw Fixation: Current Advances in Indications and Techniques.Advances and technical standards in neurosurgery · 2026Review
- Chronic type 2 odontoid fracture with atlantoaxial spondyloptosis in an adult: a case report and literature review.Journal of spine surgery (Hong Kong) · 2025Article
- [Treatment of geriatric odontoid fractures].Unfallchirurgie (Heidelberg, Germany) · 2025Article
- Treatment practices for geriatric type II odontoid fractures - A survey by the European Association of Neurosurgical Societies Spine Section.Brain & spine · 2025Article
- The management of odontoid fractures through the lens of evolution in classification schemes: A systematic review with illustrative case examples.Brain & spine · 2025Review
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Authors and funding
24 authors.
Funding
Abstract
backgroundThe optimal treatment for odontoid fractures in older people remains debated. Odontoid fractures are increasingly relevant to clinical practice due to ageing of the population.
methodsAn international prospective comparative study was conducted in fifteen European centres, involving patients aged ≥55 years with type II/III odontoid fractures. The surgeon and patient jointly decided on the applied treatment. Surgical and conservative treatments were compared. Primary outcomes were Neck Disability Index (NDI) improvement, fracture union and stability at 52 weeks. Secondary outcomes were Visual Analogue Scale neck pain, Likert patient-perceived recovery and EuroQol-5D-3L at 52 weeks. Subgroup analyses considered age, type II and displaced fractures. Multivariable regression analyses adjusted for age, gender and fracture characteristics.
resultsThe study included 276 patients, of which 144 (52%) were treated surgically and 132 (48%) conservatively (mean (SD) age 77.3 (9.1) vs. 76.6 (9.7), P = 0.56). NDI improvement was largely similar between surgical and conservative treatments (mean (SE) -11 (2.4) vs. -14 (1.8), P = 0.08), as were union (86% vs. 78%, aOR 2.3, 95% CI 0.97-5.7) and stability (99% vs. 98%, aOR NA). NDI improvement did not differ between patients with union and persistent non-union (mean (SE) -13 (2.0) vs. -12 (2.8), P = 0.78). There was no difference for any of the secondary outcomes or subgroups.
conclusionsClinical outcome and fracture healing at 52 weeks were similar between treatments. Clinical outcome and fracture union were not associated. Treatments should prioritize favourable clinical over radiological outcomes.
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