title: Teriparatide anabolic therapy as potential treatment of type II dens non-union fractures.
abstract: Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type II fractures are the most common fracture pattern in elderly patients. Treatment (rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of treatment in the elderly is to quickly restore pre-injury function while decreasing morbidity and mortality associated with inactivity, immobilization with rigid collar and prolonged hospitalization. Conservative treatment of type II odontoid fractures is associated with relatively high rates of non-union and in a few cases delayed instability. Options for treatment of symptomatic non-unions include surgical fixation or prolonged rigid immobilization. In this report we present the case of a 73-year-old woman with post-traumatic odontoid non-union successfully treated with Teriparatide systemic anabolic therapy. Complete fusion and resolution of the symptoms was achieved 12 wk after the onset of the treatment. Several animal and clinical studies have confirmed the potential role of Teriparatide in enhancing fracture healing. Our case suggests that Teriparatide may have a role in improving fusion rates of C2 fractures in elderly patients.
authors.affiliation: Enrico Pola, Virginia Pambianco, Debora Colangelo, Virginia M Formica, Giovanni Autore, Spinal Unit, Department of Orthopaedics and Traumatology, "A. Gemelli" University Hospital, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Pola
authors.affiliation: Enrico Pola, Virginia Pambianco, Debora Colangelo, Virginia M Formica, Giovanni Autore, Spinal Unit, Department of Orthopaedics and Traumatology, "A. Gemelli" University Hospital, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: Virginia
authors.initials: V
authors.lastname: Pambianco
authors.affiliation: Enrico Pola, Virginia Pambianco, Debora Colangelo, Virginia M Formica, Giovanni Autore, Spinal Unit, Department of Orthopaedics and Traumatology, "A. Gemelli" University Hospital, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Colangelo
authors.affiliation: Enrico Pola, Virginia Pambianco, Debora Colangelo, Virginia M Formica, Giovanni Autore, Spinal Unit, Department of Orthopaedics and Traumatology, "A. Gemelli" University Hospital, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Formica
authors.affiliation: Enrico Pola, Virginia Pambianco, Debora Colangelo, Virginia M Formica, Giovanni Autore, Spinal Unit, Department of Orthopaedics and Traumatology, "A. Gemelli" University Hospital, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Autore
authors.affiliation: Enrico Pola, Virginia Pambianco, Debora Colangelo, Virginia M Formica, Giovanni Autore, Spinal Unit, Department of Orthopaedics and Traumatology, "A. Gemelli" University Hospital, Catholic University of Rome, 00168 Rome, Italy.
authors.forename: Luigi A
authors.initials: LA
authors.lastname: Nasto
keywords: Anabolic therapy; Fracture healing; Non-union; Teriparatide; Type II odontoid fractures