Radiographic analysis of type II odontoid fractures in a geriatric patient population: description and pathomechanism of the “Geier”-deformity

• Published in: European spine journal Vol. 20; no. 11; pp. 1928 - 1939
• Main Authors: Reinhold, Maximilian, Bellabarba, C., Bransford, R., Chapman, J., Krengel, W., Lee, M., Wagner, T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.11.2011; Springer Nature B.V
• Subjects: Age; Aged; Aged, 80 and over; Female; Fractures; Geriatrics; Hospitals; Humans; Injuries; Kyphosis; Male; Medicine; Medicine & Public Health; Neurosurgery; Odontoid Process - diagnostic imaging; Odontoid Process - injuries; Odontoid Process - surgery; Original; Original Article; Posture; Radiography; Retrospective Studies; Spinal Fractures - diagnostic imaging; Spinal Fractures - surgery; Spine; spine (cervical); Surgical Orthopedics; Treatment Outcome; Operative non-operative treatment; Radiographic analysis; Odontoid fracture; Cervical spine; Geriatric patients
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-011-1903-6

Introduction Type II odontoid fractures are one among the most common cervical spine fractures in the elders. We reviewed a consecutive series of patients, aged 65 years and older, presenting to our institution with type II odontoid fractures. Our analysis focused on the radiographic outcome, union rate and the development of cervical spine postural deformity. Patients/methods Indications for surgical treatment (OP) included displaced or unstable injuries. Stable, non-displaced injuries or patients with significant co-morbidities were treated nonoperatively (non-op). Results Ninety patients (50 f, 40 m) with an average age of 83 years (65–101) were identified. 31 (34.4%) patients were received OP and 57 (63.3%) were received non-op treatments. The hospital length of stay was significantly longer after OP (mean 10 days vs. 6 days non-op) treatment ( p  = 0.007). At follow-up, higher union rates were noted in the OP (76.2%) than in the non-op group (58.3%). Conclusion We observed a characteristic cervical spine deformity in geriatric patients with type II odontoid fractures, and have termed this the “Geier-deformity”. Clinical findings of the deformity include sagittal imbalance and kyphosis of the lower cervical spine.