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Rigid cervical collar treatment for geriatric type II odontoid fractures

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Abstract

Purpose

To evaluate fracture healing, functional outcomes, complications, and mortality associated with rigid cervical collars.

Methods

Thirty-four patients with <50% odontoid displacement were treated with a rigid cervical collar for 12 weeks (Average age = 84 years). Outcome scores were compared with a group of 40 age-matched control subjects (Average age 79.3).

Results

At average 14.9-month follow-up, only 6% demonstrated radiographic evidence of fracture healing and 70% had mobile odontoid nonunion. NDI scores indicated only mild disability, pain scores were low, and neither differed significantly from age-matched controls. Mobile odontoid nonunion was not associated with higher levels of disability or neck pain. Mortality rate was 11.8%. Treatment complications occurred in 6% of patients.

Conclusions

Odontoid nonunion and instability are high in geriatric patients treated with a rigid cervical collar. Fracture healing and stability did not correlate with improved outcomes. Outcomes did not differ significantly from age-matched cohorts.

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Acknowledgments

The authors wish to thank Kimberly A. Napoli for assistance in preparing this manuscript.

Conflict of interest

None.

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Authors and Affiliations

  1. Orthopaedics and Rehabilitation, University of Rochester Medical Center, 601 Elmwood Ave., Box 665, Rochester, NY, 14642, USA

    Robert W. Molinari, Oner A. Khera, William L. Gruhn & Ryan W. McAssey

Authors
  1. Robert W. Molinari
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  2. Oner A. Khera
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  3. William L. Gruhn
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  4. Ryan W. McAssey
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Corresponding author

Correspondence to Robert W. Molinari.

Additional information

University of Rochester Medical Center Institutional Review Board approval was obtained prior to initiation of this study.

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Molinari, R.W., Khera, O.A., Gruhn, W.L. et al. Rigid cervical collar treatment for geriatric type II odontoid fractures. Eur Spine J 21, 855–862 (2012). https://doi.org/10.1007/s00586-011-2069-y

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  • DOI: https://doi.org/10.1007/s00586-011-2069-y

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