title: Radiographic analysis of type II odontoid fractures in a geriatric patient population: description and pathomechanism of the "Geier"-deformity.
abstract: BACKGROUND
  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.
  
  
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery/Spine Services, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Seattle, WA 98104, USA. maximilian.reinhold@i-med.ac.at
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reinhold
authors.forename: C
authors.initials: C
authors.lastname: Bellabarba
authors.forename: R
authors.initials: R
authors.lastname: Bransford
authors.forename: J
authors.initials: J
authors.lastname: Chapman
authors.forename: W
authors.initials: W
authors.lastname: Krengel
authors.forename: M
authors.initials: M
authors.lastname: Lee
authors.forename: T
authors.initials: T
authors.lastname: Wagner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging* / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome