Abstract text (incl. references and figure legends)
Introduction: Odontoid fractures are the most common fracture of the axis and the most common cervical fracture in patients over 80 years. Material and Methods: A retrospective review of C2 fractures in patients 80 years of age or older who were admitted at University Medical Centre Ljubljana from 2011 to 2019 was performed. Results: We identified 44 patients with C2 fractures with 28 patients classified as Anderson–D"Alonzo Type-II odontoid fracture. Subjects were treated either surgically (n = 5) or initially nonsurgically (n = 23) as determined by the treatment preferred of the treating physicians and the patients. The mean age was 82,8 years in the surgical and 85,7 years in the nonsurgical group (P>0,03); mean number of comorbidities was 3,2 in the nonsurgical and 3,6 in the surgical group (P>0.38); mean fracture displacement was 2,3mm in the nonsurgical and 5mm in the surgical group (P>0,0004). Acute in-hospital mortality rate was 4% in the nonsurgical group and 20% in the surgical group (P>0.24). The percentage of patients experiencing complications was higher in the nonoperative group than the operative group (34% vs. 20% (P>0.27)). In surgical group there was no nonunion in nonsurgical group there was 0,34 of nonunion (P>0,001). One year survival rate in surgical group was 80% and nonsurgical group 87% (P>0,37). Five year survival rate was 60% in the surgical group and 39% in nonsurgical group (P>0,23). Conclusion:Mean displacement was significant larger in group of patients that were operated. Operative treatment provides significant better fusion rate than external immobilization for acute odontoid Type ІІ fractures in the geriatric population. There was no significant difference between 1- and 5-year survival rates in patients treated operatively or nonoperatively.
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