Patel AA, Lindsey R, Bessey JT, Chapman J, Rampersaud R, Spine Trauma Study Group. The best surgical treatment for type II fractures of the dens is still controversial. 2010 35(21 Suppl):S219–27.ĭenaro V, Papalia R, Di Martino A, Denaro L, Maffulli N. Optimal treatment for odontoid fractures in the elderly. Isolated fractures of the axis in adults. The optimal treatment of type II and III odontoid fractures in the elderly: a systematic review. Huybregts JG, Jacobs WC, Vleggeert-Lankamp CL. Evidence-based management of type II odontoid fractures. Type II odontoid fractures in the elderly: an evidence-based narrative review of management. A systematic review of efficacy and safety. Upper cervical spine injuries: indications and limits of the conservative management in Halo vest. Longo UG, Denaro L, Campi S, Maffulli N, Denaro V. Evidence-based analysis of odontoid fracture management. Julien TD, Frankel B, Traynelis VC, Ryken TC. Surgical versus conservative management for odontoid fractures. Operative versus nonoperative management of acute odontoid Type II fractures: a meta-analysis. Nourbakhsh A, Shi R, Vannemreddy P, Nanda A. Anterior cervical discectomy and fusion for unstable traumatic spondylolisthesis of the axis. Ying Z, Wen Y, Xinwei W, Yong T, Hongyu L, Zhu H, Qinggang Z, Weihong Z, Yonggeng C. Cervical crossing laminar screws: early clinical results and complications. Outcomes of C1 and C2 posterior screw fixation for upper cervical spine fusion. Fractures of the odontoid process of the axis. Factors of severity in the fractures of the odontoid process (author’s transl). Roy-Camille R, Saillant G, Judet T, de Botton G, Michel G. Odontoid process fractures associated with fractures of the pedicles of the axis (author’s transl). Roy-Camille R, Bleynie JF, Saillant G, Judet T. New subtype of acute odontoid fractures (type IIA). Hadley MN, Browner CM, Liu SS, Sonntag VK. The treatment algorithm for odontoid fractures continues to evolve based on the improved understanding of, and evidence-based literature on, anterior screw fixation, posterior spinal fusion, and halo-vest immobilization.Anderson LD, D’Alonzo RT. However, these clinical decisions have been associated with a significant rate of complications. Increased familiarity with anterior and posterior surgical techniques has led to more aggressive treatment of odontoid fracture, with the intent of hastening functional rehabilitation. The decision-making process is particularly difficult when treating elderly patients. Type III: fracture extends into the body of the axis. Type II: fracture through the base of the dens, at the junction of the odontoid base and the body of C2. Thus, new classification systems have been devised to identify patients who might benefit from early surgical treatment. Epidemiology /Etiology Type I: avulsion fracture of the apex. Nonsurgical management of type II odontoid fracture has historically been associated with a high nonunion rate. Recognition of the incidence of odontoid fractures as well as the associated morbidity and unexpectedly high mortality rates has prompted significant changes in the management of these fractures in the past decade.
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