Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies

Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of th...
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Autor*in:	Oliver Gembruch [verfasserIn] Elias Lemonas [verfasserIn] Yahya Ahmadipour [verfasserIn] Ulrich Sure [verfasserIn] Nicolai El Hindy [verfasserIn] Richard Dodel [verfasserIn] Oliver Müller [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Odontoid fracture Geriatric patients Conservative management Surgical management Mortality Complication rate

Übergeordnetes Werk:	In: Neurospine - Korean Spinal Neurosurgery Society, 2019, 16(2019), 2, Seite 360-367
Übergeordnetes Werk:	volume:16 ; year:2019 ; number:2 ; pages:360-367

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.14245/ns.1836250.125

Katalog-ID:	DOAJ074205005

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520			\|a Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities.
650		4	\|a Odontoid fracture
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allfields	10.14245/ns.1836250.125 doi (DE-627)DOAJ074205005 (DE-599)DOAJ87df3f6414a7430ab3fdcba618f7367a DE-627 ger DE-627 rakwb eng RC346-429 Oliver Gembruch verfasserin aut Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities. Odontoid fracture Geriatric patients Conservative management Surgical management Mortality Complication rate Neurology. Diseases of the nervous system Elias Lemonas verfasserin aut Yahya Ahmadipour verfasserin aut Ulrich Sure verfasserin aut Nicolai El Hindy verfasserin aut Richard Dodel verfasserin aut Oliver Müller verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 2, Seite 360-367 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:2 pages:360-367 https://doi.org/10.14245/ns.1836250.125 kostenfrei https://doaj.org/article/87df3f6414a7430ab3fdcba618f7367a kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1836250-125.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 2 360-367
spelling	10.14245/ns.1836250.125 doi (DE-627)DOAJ074205005 (DE-599)DOAJ87df3f6414a7430ab3fdcba618f7367a DE-627 ger DE-627 rakwb eng RC346-429 Oliver Gembruch verfasserin aut Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities. Odontoid fracture Geriatric patients Conservative management Surgical management Mortality Complication rate Neurology. Diseases of the nervous system Elias Lemonas verfasserin aut Yahya Ahmadipour verfasserin aut Ulrich Sure verfasserin aut Nicolai El Hindy verfasserin aut Richard Dodel verfasserin aut Oliver Müller verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 2, Seite 360-367 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:2 pages:360-367 https://doi.org/10.14245/ns.1836250.125 kostenfrei https://doaj.org/article/87df3f6414a7430ab3fdcba618f7367a kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1836250-125.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 2 360-367
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allfieldsGer	10.14245/ns.1836250.125 doi (DE-627)DOAJ074205005 (DE-599)DOAJ87df3f6414a7430ab3fdcba618f7367a DE-627 ger DE-627 rakwb eng RC346-429 Oliver Gembruch verfasserin aut Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities. Odontoid fracture Geriatric patients Conservative management Surgical management Mortality Complication rate Neurology. Diseases of the nervous system Elias Lemonas verfasserin aut Yahya Ahmadipour verfasserin aut Ulrich Sure verfasserin aut Nicolai El Hindy verfasserin aut Richard Dodel verfasserin aut Oliver Müller verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 2, Seite 360-367 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:2 pages:360-367 https://doi.org/10.14245/ns.1836250.125 kostenfrei https://doaj.org/article/87df3f6414a7430ab3fdcba618f7367a kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1836250-125.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 2 360-367
allfieldsSound	10.14245/ns.1836250.125 doi (DE-627)DOAJ074205005 (DE-599)DOAJ87df3f6414a7430ab3fdcba618f7367a DE-627 ger DE-627 rakwb eng RC346-429 Oliver Gembruch verfasserin aut Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities. Odontoid fracture Geriatric patients Conservative management Surgical management Mortality Complication rate Neurology. Diseases of the nervous system Elias Lemonas verfasserin aut Yahya Ahmadipour verfasserin aut Ulrich Sure verfasserin aut Nicolai El Hindy verfasserin aut Richard Dodel verfasserin aut Oliver Müller verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 2, Seite 360-367 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:2 pages:360-367 https://doi.org/10.14245/ns.1836250.125 kostenfrei https://doaj.org/article/87df3f6414a7430ab3fdcba618f7367a kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1836250-125.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 2 360-367
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The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. 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author	Oliver Gembruch
spellingShingle	Oliver Gembruch misc RC346-429 misc Odontoid fracture misc Geriatric patients misc Conservative management misc Surgical management misc Mortality misc Complication rate misc Neurology. Diseases of the nervous system Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies
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topic_title	RC346-429 Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies Odontoid fracture Geriatric patients Conservative management Surgical management Mortality Complication rate
topic	misc RC346-429 misc Odontoid fracture misc Geriatric patients misc Conservative management misc Surgical management misc Mortality misc Complication rate misc Neurology. Diseases of the nervous system
topic_unstemmed	misc RC346-429 misc Odontoid fracture misc Geriatric patients misc Conservative management misc Surgical management misc Mortality misc Complication rate misc Neurology. Diseases of the nervous system
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title	Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies
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title_sort	treatment of odontoid type ii fractures in octogenarians: balancing two different treatment strategies
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title_auth	Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies
abstract	Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities.
abstractGer	Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities.
abstract_unstemmed	Objective Demographic changes have led to a higher incidence of C-2 fractures, especially in elderly patients. For patients with type II fractures, treatment remains controversial, as discussed by Anderson and D’Alonzo, due to the rising morbidity and mortality rates for any treatment. The aim of this study was to compare conservative and surgical management in patients with type II C-2 fractures regarding outcomes, complications, and the mortality rate. Methods A retrospective analysis was performed of the medical records, X-rays, and/or computed tomography scans of patients ≥80 years of age with type II fractures who were admitted to our Department of Neurosurgery between January 1990 and December 2017. The success of treatment was evaluated 3 months after surgery. Results In total, 125 patients were included, of whom 98 were treated surgically and 27 were treated conservatively. Surgical treatment was successful in 90.8% of cases, while conservative treatment was successful in 70.0%. The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. Therefore, we conclude that surgical treatment for type II fractures in elderly patients is superior to conservative management, although conservative treatment remains a valuable option in elderly patients with severe comorbidities.
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title_short	Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies
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The in-hospital mortality was 14.29% and the 3-month mortality was 27.8% in the surgical group, compared to 3.7% and 20% in the conservatively treated group. The in-hospital complication rate was 22.4% in the surgically treated patients and 7.4% in the conservatively treated patients. Conclusion Surgical treatment of type II fractures seemed to be associated with higher success and complication rates than conservative treatment. Nevertheless, 3-month mortality was comparable in both groups. 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Treatment of Odontoid Type II Fractures in Octogenarians: Balancing Two Different Treatment Strategies

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