Radiological Features in Type II Odontoid Fractures in Older Adults After High- and Low-Energy Trauma.

Document Type


Publication Date


Publication Title

Global Spine J


washington; swedish neuro; cervical malalignment; cervical spine; elderly; high-energy trauma; low-energy trauma; osteoporosis; trauma; type II odontoid fractures


STUDY DESIGN: Retrospective study.

OBJECTIVES: Although type II odontoid fractures mainly occur due to high-energy trauma (HET), the number of odontoid type II fractures after low-energy trauma (LET) in the elderly is on the rise. However, there is a paucity of conclusive evidence on the relationship between trauma mechanism and cervical spine alignment in the elderly population. Consequently, we examined cervical alignment and osteoporotic and osteoarthritic patterns in elderly individuals (aged ≥65 years) with type II odontoid fractures.

METHODS: We retrospectively assessed cervical spine alignment in 76 elderly individuals who experienced type II odontoid fractures after HET (n = 36) and LET (n = 40) between 2005 and 2020. Osteoporotic and osteoarthritic changes on computed tomography and cervical alignment parameters on sagittal plane radiographs were examined.

RESULTS: Moderate and severe osteoporosis of the dens-body junction and osteoarthritis of the atlanto-odontoid joint were more prevalent in the LET than the HET group (

CONCLUSION: Significantly higher rates of osteoporotic and degenerative changes were observed after LET. Furthermore, previous cervical malalignment represents a risk factor for type II odontoid fractures after LET.

Clinical Institute

Neurosciences (Brain & Spine)