Artikel
Anterior screw fixation of type II odontoid fractures according to Anderson & D’Alonzo in elderly and geriatric patients – clinical and radiological outcome
Ventrale Schraubenosteosynthese von Densfrakturen Typ II nach Anderson & D’Alonzo bei älteren und geriatrischen Patienten – klinisches und radiologisches Outcome
Suche in Medline nach
Autoren
Veröffentlicht: | 25. Mai 2022 |
---|
Gliederung
Text
Objective: An increasingly aging society in Western industrialized nations continues challenge established precedents in modern medicine, mandating adaptation to this demographic shift. In this context, odontoid fractures constitute one of the most common trauma-related injuries and the most frequent injury of the cervical spine in the elderly. Although anterior screw fixation represents a common and minimal invasive treatment for type II odontoid fractures according to D'Alonzo & Anderson, there is no clear consensus on the benefits of surgical management in elderly and especially geriatric patients.
Methods: In this retrospective study, we evaluated the surgical outcome following anterior screw fixation for type II odontoid fractures according to Anderson & D'Alonzo and in a total of 27 patients, dichotomized into the age group of 55 to 75 years (Group 1: elderly) and above 75 years (Group 2: geriatric). Postoperative assessment was carried out by evaluating the rate of consolidation on CT-scans and assessment of Neck Disability Index (NDI). Statistical analysis was performed using SPSS 22.0 (IBM) by Mann–Whitney test and p values
Results: The postoperative consolidation rate following ventral screw osteosynthesis in the patient group of over 75 years of age constituted 24 %, showing a significantly worse result than in the patient group of 55 to 75 years with a postoperative consolidation rate of 60 % (p=0.046). Evaluation of the results of the Neck Disability Index (NDI) showed a correspondingly lesser reduction in symptoms in the geriatric patient group with NDI of 18.6 in comparison to the elderly patient group with NDI of 26.3 (p=0.035).
Conclusion: The results of our retrospective study suggest that geriatric patients (older than 75 years) benefit less from anterior screw fixation of odontoid fractures than elderly patients (55 – 75 years). The very low consolidation rate in conjunction with postoperative persistence of symptoms challenges the justification for surgical management of type II fractures with ventral screw osteosynthesis in geriatric patients.