Treatment protocol for fractures of the odontoid process

Kazuhiro Chiba, Yoshikazu Fujimura, Yoshiaki Toyama, Eiji Fujii, Tadayuki Nakanishi, Kiyoshi Hirabayashi

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72 Citations (Scopus)


Treatment results in 104 patients with odontoid fractures were reviewed. There were 2 type I, 62 type II, 32 type III fractures and eight epiphysiolyses in children <7 years old. Thirty-seven patients were managed nonoperatively using plaster casts, cervical braces, or halo devices. Sixty- seven patients were treated surgically including anterior screw fixation (ASF), posterior fusion (PF), and transoral anterior fusion (TAF). Plaster cants and cervical braces were effective for type I fractures and epiphysiolyses truly. Halo devices provided successful results in stable type III fractures. ASF is the treatment of choice for most type II and unstable III fractures including some old cases. PF also provided successful union, although impaired cervical motion remained. It should be reserved for irreducible fractures, established nonunions, and as a salvage procedure. TAF should be limited to exceptional cases requiring anterior spinal cord decompression.

Original languageEnglish
Pages (from-to)267-276
Number of pages10
JournalJournal of Spinal Disorders
Issue number4
Publication statusPublished - 1996 Sept 22


  • Anterior screw fixation
  • Dens fracture
  • Nonoperative treatment
  • Odontoid fracture
  • Surgical treatment
  • Treatment results
  • Upper cervical spine injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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