Healing of type II odontoid fracture without surgery in an octogenarian — Case report and literature review

Tej D. Azad, Bowen Jiang, Alex M. Zhu, Nicholas Theodore

Research output: Contribution to journalArticlepeer-review

Abstract

Odontoid fractures are the most common cervical spine fracture in the elderly. There is considerable controversy regarding the optimal management of type II odontoid fractures in this population. We present the case of an 89-year-old woman presented with neck pain after a mechanical fall. She was neurologically intact. Computed tomography (CT) of the cervical spine revealed a Type II odontoid fracture with 4.4 mm of posterior displacement. Given the patient's extensive medical comorbidities, non-operative management with a rigid cervical orthosis was elected. The patient underwent serial imaging and routine clinical follow up. CT scan at one-year follow-up demonstrated complete osseous union. The patient's neck pain resolved and her cervical collar was discontinued. The risk benefit profile for surgical intervention in elderly patients with Type II odontoid fractures must be weighed against the morbidity associated with prolonged cervical immobilization. This case highlights the importance of serial surveillance imaging and demonstrates that complete arthrodesis can be achieved even in the elderly with prolonged cervical immobilization alone.

Original languageEnglish (US)
JournalJournal of Clinical Neuroscience
DOIs
StatePublished - Jan 1 2019

Keywords

  • Conservative management
  • Dens
  • Octogenarian
  • Odontoid fracture

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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