Odontoid Fractures in the Elderly

J Spinal Disord. 1993 Oct;6(5):397-401. doi: 10.1097/00002517-199306050-00005.


A review of 35 patients > 60 years of age with odontoid fractures showed that a type II injury (Anderson and D'Alonso) was the most common fracture pattern (82% of cases). On the basis of mechanism of injury and sex incidence, we deduced that osteopenia is a contributory factor in the occurrence of odontoid fractures. A fall in a domestic setting was the cause in 53%. The peg was posteriorly displaced in 88% of type II fractures, and primary union occurred in 23%. The incidence of concomitant spinal cord injury with type II fractures was higher in older patients than it was in those < 60 years of age. The outcome for these patients was largely determined by their neurological status at presentation. Myelopathy as a late complication of nonunion was not observed in nine patients with an average follow-up of 21 months. The data suggest that vigorous attempts to secure both primary union and a sound arthrodesis for non-union are questionable in the elderly except in unusual circumstances.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Diseases, Metabolic / complications
  • Female
  • Follow-Up Studies
  • Fractures, Ununited
  • Humans
  • Male
  • Middle Aged
  • Odontoid Process / injuries*
  • Retrospective Studies
  • Severity of Illness Index
  • Spinal Fractures* / etiology
  • Spinal Fractures* / therapy
  • Treatment Outcome