gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Long-term outcome of C2-fractures

Langzeitergebnisse bei C2-Frakturen

Meeting Abstract

  • corresponding author B. Muskala - Klinik für Neurochirurgie, Otto-von-Guericke-Universität Magdeburg
  • B. Jöllenbeck - Klinik für Neurochirurgie, Otto-von-Guericke-Universität Magdeburg
  • R. Firsching - Klinik für Neurochirurgie, Otto-von-Guericke-Universität Magdeburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 11.187

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Muskala et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: There are numerous surgical techniques to stabilize C2-fractures, but there is little data on long-term outcome. We evaluated the outcome of 60 patients with a mean follow-up of 3 years.

Methods: During the period of 1995-2005 N=60 patients with C2-fractures were treated. The clinical and radiographic records are reviewed retrospectively.

Results: There were four Type I, twelve Type II and 34 Type III fractures identified according to the classification of odontoid fractures by Anderson and D’Alonzo. All Type I fractures were treated by cervical immobilization with a satisfying stabilisation. Anterior single screw fixation was performed in ten cases of Type II fracture sufficiently. Another two patient with a Type II fracture needed additional posterior C1/C2 fixation: in one case because of rheumatoid arthritis and a screw fracture, in another case the surgical anterior screw fixation was impossible because of pseudarthrosis. 18 of 34 patients with Type III fractures were treated successfully with anterior screw fixation and 16 patients by cervical immobilization. Two of these 16 patients developed a pseudarthrosis and had to be treated by additional dorsal fixation. Four patients with a traumatic spondylolisthesis were treated by anterior fixation with a satisfying stabilisation. Seven cases of fractures of the arch were sufficiently treated by cervical immobilization. Long-term outcome was good to excellent in 80%, moderate in 12% and poor in 8%.

Conclusions: The results justify the use of anterior screw fixation as the primary treatment of choice for Type II odontoid fractures when feasible. The treatment of Type III fractures may involve various techniques and must consider osteoporosis, patients' compliance and additional lesions.