Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section
Introduction: Controversy exists regarding the optimal management of type II odontoid fractures in the geriatric population. The objective of this study was to determine the current treatment patterns of spine surgeons for geriatric patients (≥70 years) with type II odontoid fractures. Research ques...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425001146 |
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| author | Ralph T. Schär Jefferson R. Wilson Marcel Ivanov Giuseppe Barbagallo Yana Petrova Carla Reizinho Maria Luisa Gandia González Enrico Tessitore Andrzej Maciejczak Nikolay Gabrovsky Bart Depreitre Ehab Shiban Andreas K. Demetriades Florian Ringel |
| author_facet | Ralph T. Schär Jefferson R. Wilson Marcel Ivanov Giuseppe Barbagallo Yana Petrova Carla Reizinho Maria Luisa Gandia González Enrico Tessitore Andrzej Maciejczak Nikolay Gabrovsky Bart Depreitre Ehab Shiban Andreas K. Demetriades Florian Ringel |
| author_sort | Ralph T. Schär |
| collection | DOAJ |
| description | Introduction: Controversy exists regarding the optimal management of type II odontoid fractures in the geriatric population. The objective of this study was to determine the current treatment patterns of spine surgeons for geriatric patients (≥70 years) with type II odontoid fractures. Research question: How much do treatment practices for type II odontoid fractures in the geriatric population differ amongst spine surgeons? Methods: The European Association of Neurosurgical Societies (EANS) Spine Section distributed a 39-items web-based survey among spine surgeons between July 2024 and February 2025. Results: A total of 154 responses were collected from 119 neurosurgeons (77.8 %) and 34 orthopedic surgeons (22.2 %). Participants were predominantly from Europe (92.7 %), and 63.2 % have been in practice >10 years. Fracture displacement, comorbidities and age were the most influential factors for decision-making. For non-displaced fractures, 78.8 % of respondents recommended conservative treatment for patients aged 70–80 years, and 83.7 % for those aged 80–90 years. For displaced fractures, 70.9 % preferred surgery for patients aged 70–80 years, whereas this preference decreased to 47.9 % for those aged 80–90 years. Posterior C1-2 fixation was the most common technique for 67.3 % of respondents, and 48.3 % prescribe a collar postoperatively. 51.3 % routinely order CT imaging postoperatively to assess for bony fusion. For conservative treatment, 59.3 % prescribe an external orthosis for 3 months. Discussion and conclusion: Our survey found both variability and consistency in treatment practices of geriatric type II odontoid fractures, reflecting the ongoing debate and lack of consensus in clinical decision-making. |
| format | Article |
| id | doaj-art-d0b69e41e7eb42d38557699b44285c0f |
| institution | DOAJ |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-d0b69e41e7eb42d38557699b44285c0f2025-08-20T03:21:38ZengElsevierBrain and Spine2772-52942025-01-01510429510.1016/j.bas.2025.104295Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine SectionRalph T. Schär0Jefferson R. Wilson1Marcel Ivanov2Giuseppe Barbagallo3Yana Petrova4Carla Reizinho5Maria Luisa Gandia González6Enrico Tessitore7Andrzej Maciejczak8Nikolay Gabrovsky9Bart Depreitre10Ehab Shiban11Andreas K. Demetriades12Florian Ringel13Department of Neurosurgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; Corresponding author. Department of Neurosurgery Inselspital, Bern University Hospital, and University of Bern Rosenbühlgasse, 253010, Bern, Switzerland.Department of Surgery, Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, CanadaRoyal Hallamshire Hospital, Sheffield, UKDepartment of Neurosurgery, University of Catania, Catania, ItalyDepartment of Neurosurgery, University Hospital Sofiamed, Sofia, BulgariaDepartamento de Neurocirurgia, Hospital Egas Moniz, Unidade Local de Saúde Lisboa Ocidental, Hospital da Luz, Lisbon, PortugalDepartment of Neurosurgery, University Hospital La Paz, Madrid, SpainDepartment of Neurosurgery, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Neurosurgery, St Lukas Hospital, Tarnów, Poland, Medical Faculty, University of Rzeszów, PolandClinic of Neurosurgery, University Hospital Pirogov, Sofia, BulgariaDepartment of Neurosurgery, University Hospitals Leuven, Leuven, BelgiumDepartment of Neurosurgery, Lausitz University Hospital, Cottbus, GermanyDepartment of Neurosurgery, Royal Infirmary Edinburgh, NHS Lothian, Edinburgh, UKDepartment of Neurosurgery, LMU University Hospital, LMU Munich, GermanyIntroduction: Controversy exists regarding the optimal management of type II odontoid fractures in the geriatric population. The objective of this study was to determine the current treatment patterns of spine surgeons for geriatric patients (≥70 years) with type II odontoid fractures. Research question: How much do treatment practices for type II odontoid fractures in the geriatric population differ amongst spine surgeons? Methods: The European Association of Neurosurgical Societies (EANS) Spine Section distributed a 39-items web-based survey among spine surgeons between July 2024 and February 2025. Results: A total of 154 responses were collected from 119 neurosurgeons (77.8 %) and 34 orthopedic surgeons (22.2 %). Participants were predominantly from Europe (92.7 %), and 63.2 % have been in practice >10 years. Fracture displacement, comorbidities and age were the most influential factors for decision-making. For non-displaced fractures, 78.8 % of respondents recommended conservative treatment for patients aged 70–80 years, and 83.7 % for those aged 80–90 years. For displaced fractures, 70.9 % preferred surgery for patients aged 70–80 years, whereas this preference decreased to 47.9 % for those aged 80–90 years. Posterior C1-2 fixation was the most common technique for 67.3 % of respondents, and 48.3 % prescribe a collar postoperatively. 51.3 % routinely order CT imaging postoperatively to assess for bony fusion. For conservative treatment, 59.3 % prescribe an external orthosis for 3 months. Discussion and conclusion: Our survey found both variability and consistency in treatment practices of geriatric type II odontoid fractures, reflecting the ongoing debate and lack of consensus in clinical decision-making.http://www.sciencedirect.com/science/article/pii/S2772529425001146Type II odontoid fractureEuropean Association of Neurosurgical SocietiesSurveyGeriatric populationSpine surgery |
| spellingShingle | Ralph T. Schär Jefferson R. Wilson Marcel Ivanov Giuseppe Barbagallo Yana Petrova Carla Reizinho Maria Luisa Gandia González Enrico Tessitore Andrzej Maciejczak Nikolay Gabrovsky Bart Depreitre Ehab Shiban Andreas K. Demetriades Florian Ringel Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section Brain and Spine Type II odontoid fracture European Association of Neurosurgical Societies Survey Geriatric population Spine surgery |
| title | Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section |
| title_full | Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section |
| title_fullStr | Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section |
| title_full_unstemmed | Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section |
| title_short | Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section |
| title_sort | treatment practices for geriatric type ii odontoid fractures a survey by the european association of neurosurgical societies spine section |
| topic | Type II odontoid fracture European Association of Neurosurgical Societies Survey Geriatric population Spine surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425001146 |
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