Odontoid fractures: factors involved in deciding on effective therapy

Abstract

The odontoid process (AO) is a bony eminence that is located in the vertebral body of the axis (C2) in its anterior part. Odontoid fractures (OF) are frequently caused by low-power impacts or falls in older adults and higher-power accidents in young people. The most common mechanism of injury is hyperextension of the cervical spine. The diagnosis is based on imaging studies that allow the observer to use the Anderson and D’Alonzo classification in conjunction with the Grauer classification for odontoid fracture types. In addition, this classification allows to evaluate the most appropriate therapeutic method. The objective of this review is to demonstrate which are the most important factors when deciding on a treatment for odontoid fractures and the efficacy of the different therapies currently applied to these conditions. In conclusion, it became evident that, when choosing the treatment, the two fundamental factors are the patient’s age and comorbidities, although surgical treatment has given better results than immobilization, it does not operate because of the patient’s condition.