Maximilian Reinhold, C. Bellabarba, R. Bransford, J. Chapman, W. Krengel, M. Lee, T. Wagner

October 2011, Volume 20, Issue 11, pp 1928 - 1939 Original Article Read Full Article 10.1007/s00586-011-1903-6

First Online: 28 July 2011


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.


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).


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%).


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.

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