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Rigid cervical collar treatment for geriatric type II odontoid fractures

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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.

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Correspondence to Robert W. Molinari.

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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).

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