European Spine Journal

, Volume 20, Issue 11, pp 1915–1920 | Cite as

Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients

  • Michael OstiEmail author
  • Helmut Philipp
  • Berthold Meusburger
  • Karl Peter Benedetto
Original Article


Anterior screw fixation of Type II odontoid fractures has been recommended. Only few publications analyse the mechanism of failure in geriatric patients. We reviewed 18 male and 15 female patients aged 65 and above for parameters that influence the development of postoperative loss of correction, delayed union or non-union. Patients were stratified in two groups: 21 cases in Group A (union) and 12 patients in Group B (loss of correction, delayed union, non-union, revision surgery). Statistically significant correlation (p < 0.05) could be detected between failure to heal and: (1) degenerative changes in the atlanto-odontoid joint, (2) severity of osteoporosis in the odontoid process, (3) posterior oblique fracture type, (4) suboptimal fracture reduction, (5) suboptimal position of implant following demanding intraoperative conditions, (6) quality of fracture compression and (7) severity of fracture comminution. The overall morbidity and mortality rates were 29.0 and 8.6%, respectively. Our results indicate that these factors should be addressed regarding the selection of the operative treatment method in the geriatric patient.


Odontoid fracture Anterior screw fixation Geriatric patient Failure analysis 


Conflict of interest



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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Michael Osti
    • 1
    Email author
  • Helmut Philipp
    • 1
  • Berthold Meusburger
    • 1
  • Karl Peter Benedetto
    • 1
  1. 1.Department of Trauma Surgery and Sports TraumatologyAcademic Hospital FeldkirchFeldkirchAustria

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