Predictors of treatment outcomes in geriatric patients with odontoid fractures: AOSpine North America multi-centre prospective GOF study

Part of the Surgery Commons This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship.Predictors of treatment outcomes in geriatric patients with odontoid fractures: AOSpine North America multi-centre prospective GOF study. Study Design. Multicenter prospective cohort study. Objective. To identify patient and treatment characteristics associated with treatment success or failure in the management of odontoid fractures. Summary of Background Data. Odontoid fractures are the most common cervical spine fractures in the elderly and represent a signifi cant management challenge with widely divergent views regarding operative versus nonoperative management. Methods. A total of 159 patients 65 years and older with radiographically confi rmed type II odontoid fractures were enrolled at 10 sites in the United States and 1 site in Canada between January 2006 and May 2009. Subjects were followed at 6 and 12 months post–initial treatment with Neck Disability Index and SF-36v2 scores. Final treatment outcome was classifi ed as failure or success. Treatment failure was defi ned as death by any cause, decline in Neck Disability Index by more than 9.5 absolute points, or occurrence of a major treatment-related complication. Baseline characteristics between the groups were compared using t test for the continuous variables and χ 2 test for the categorical variables. O dontoid fractures comprise 11% of all traumatic cer-vical spine injuries, with type II odontoid fractures accounting for 40% to 60% of these fractures. Within the geriatric population, type II odontoid fractures are the most common cervical spine injury and commonly occur because of low-energy falls to the same level. 4 , 5 With the geriatric population representing the fastest growing demographic segment in North America, the number of geriatric odontoid fractures is increasing. 6 , 7 Although geriatric patients generally sustain this injury without neurological damage, these patients often have signifi cant medical comorbidities that increase mortality. 4 , 7 , 8 Elderly patients are more likely to experience signifi cant complications as a result of treatment, including nonunion, morbidity, and mortality. 6 , 9 Despite …