Further studies are required to confirm these results.ġ. Although WHO osteoporosis definition excludes cervical fractures, odontoid fracture may be considered as an osteoporotic fracture. Our study reveals that odontoid fractures mainly occur in elderly osteoporotic patients after a low energy impact. (1 patient: humeral and vertebral fracture on VFA, This injury occurs most typically when there is an excessive extension of the cervical spine, and the anterior arch of C1 pushes dorsally (backward) with sufficient force on the odontoid process (dens) to fracture the odontoid process at its base. Serum vitamin D concentration was -1 DSīoth patients had vertebral fracture on VFA) A type II odontoid fracture is a fracture through the base of the odontoid process. 2 patients with T-score > -1.DS didn’t have hip BMD assessment because of bilateral hip replacement but had previous major osteoporotic fractures. The table summarizes population bone status: 8 patients out of 10 fulfilled diagnostic criteria of osteoporosis, including 6 with previous fractures. VFA analysis revealed 4 unknown vertebral fractures. 3 patients had previously received hormone replacement therapy, 1 received bisphosphonate for 5 years and 4 had calcium + vitamin D supplements.
Evaluation included demographic data, clinical risk factors of osteoporosis, bone mineral density (BMD) at spine and hip and vertebral fracture assessment (VFA) by dual X-ray absorptiometry and serum analysis to detect secondary osteoporosis.ģ8 patients were hospitalized for odontoid fracture: 8 patients 3 months). An evaluation of bone status was proposed within 3 months after fracture event. We conducted a prospective study from January 2016 to January 2017 in patients > 65 years old, hospitalized in Nice University hospital for low energy odontoid fracture. To investigate bone status in elderly patients sustaining a low energy odontoid fracture. However, in atraumatic odontoid fractures, mainly reported by orthopedic surgeons, bone status has not been described yet. The treatment algorithm for odontoid fractures continues to evolve based on the improved understanding of, and evidence-based literature on, anterior screw fixation, posterior spinal fusion, and halo-vest immobilization.Current WHO definition of osteoporosis excludes cervical fractures. However, these clinical decisions have been associated with a significant rate of complications. Increased familiarity with anterior and posterior surgical techniques has led to more aggressive treatment of odontoid fracture, with the intent of hastening functional rehabilitation. The decision-making process is particularly difficult when treating elderly patients. Type-II odontoid fractures are associated with higher nonunion rates compared with Type I and Type III. Thus, new classification systems have been devised to identify patients who might benefit from early surgical treatment. Odontoid fractures are common cervical spine fractures with a bimodal age distribution, which is gradually shifting to more representation in the elderly population. Nonsurgical management of type II odontoid fracture has historically been associated with a high nonunion rate. Recognition of the incidence of odontoid fractures as well as the associated morbidity and unexpectedly high mortality rates has prompted significant changes in the management of these fractures in the past decade.