Surgical vs nonoperative treatment of Hadley type IIA odontoid fractures

Neurosurgery
Silke AldrianPatrick Platzer

Abstract

Type II odontoid fractures with additional chip fragments are rare in clinical practice, accounting for < 10% of all odontoid fractures. Hadley et al were the first to describe these fractures as an individual subtype (IIA). To analyze the outcome of patients after surgical or nonoperative treatment of Hadley type IIA odontoid fractures. We analyzed the records of 46 patients at an average of 64 years of age at the time of injury. Twenty-five patients underwent surgical stabilization by anterior screw fixation and were entered into study group A; 21 patients were treated nonoperatively by halo vest immobilization and included in study group B. Thirty-seven patients (84%) returned to their preinjury activity level and were satisfied with their treatment. Using the Cervical Spine Outcomes Questionnaire to quantify the clinical outcome, we had an overall outcome score of 21.8. We did not find a significant difference in the overall clinical outcome between study groups. Bony fusion was achieved in 35 patients (80%). We had a nonunion rate of 13% after anterior screw fixation and a significantly higher rate of 30% after halo vest immobilization. Failure of reduction or fixation occurred in 12 patients (27%), with a significantly hi...Continue Reading

References

Jan 1, 1988·Neurosurgery·M N HadleyV K Sonntag
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May 22, 1996·JAMA : the Journal of the American Medical Association·M A Rozner
Aug 1, 1997·Acta Orthopaedica Scandinavica·U Berlemann, O Schwarzenbach
Nov 7, 1999·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·E J MüllerG Muhr
Apr 15, 2000·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·S AnderssonC Olerud
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Jul 5, 2005·Injury·Germán Ochoa
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Jul 25, 2006·Neurosurgical Focus·T D JulienT C Ryken
Aug 3, 2007·The Journal of Bone and Joint Surgery. American Volume·Patrick PlatzerChristian Gaebler

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Citations

Jan 3, 2015·Journal of Neurosurgery. Spine·Luc TerreauxKevin Buffenoir
Aug 30, 2019·Clinical Spine Surgery : a Spine Publication·André D CarvalhoRicardo Rodrigues-Pinto
Jun 20, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ivan LvovVladimir Krylov
Dec 1, 2011·Global Spine Journal·Andrei F Joaquim, Alpesh A Patel

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