Scientists from Northwestern University in Chicago found that surgical stabilization of an odontoid fracture can reduce the chance of death by 41%. Research published in the journal brain surgery.
Fractures of the odontoid process of the second cervical vertebra are often found in elderly patients, as well as in traffic accident victims. Whether surgical or conservative treatment is optimal is still unknown.
In the new study, researchers analyzed treatment data from 296 patients treated at Northwestern Memorial Hospital between January 1, 2010, and December 31, 2020. Their average age was 73 years. During their hospitalization, 22% were operated and 78% were treated conservatively.
The researchers found that surgical stabilization led to better outcomes when age, gender, severity of injury, number of chronic diseases, and presence of bad habits were taken into account.
During surgery, fractures healed better in humans, while neurological disorders due to damage to the spinal cord (for example, movement disorder) occurred less frequently. Additionally, those who underwent surgery were 41% less likely to die after rehabilitation (about one year after surgery). The 30-day mortality rate was 13.8% in the conservative treatment group and 1.7% in the operated group.
The study showed that surgery should be considered as initial therapy for many patients.
“Given the increasing incidence of odontoid fractures in an aging population, we believe our findings may provide information for neurosurgical decisions for an increasingly common and complex problem,” the researchers said.
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