Conservative Management for Odontoid Cervical Fractures: Halo or Rigid Cervical Collar?

Abstract

Odontoid fractures are the most common fractures of the cervical spine, especially in the elderly. They account for approximately one third of cervical spine fractures, and with the aging of the world population, the incidence and clinical and social relevance of such pathology are likely to increase. Odontoid fractures may occur from high-energy mechanisms, particularly in younger patients, but low-energy trauma may be the causative factor in the geriatric population. Overall, the treatment of patients with odontoid process fractures is based on the type of the fracture, patient's health status, age, association with neurologic deficits, and personal preference of the surgeon. Relative indications for surgery include a >5-mm fracture dislocation, a >10-degree angulation, and failed attempts at closed reduction.