To evaluate fracture healing, functional outcomes, complications, and mortality associated with rigid cervical collars.
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).
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.
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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The authors wish to thank Kimberly A. Napoli for assistance in preparing this manuscript.
Conflict of interest
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