Shears, Cochrane Database Syst Rev 2008 - Surgical versus Conservative Management for Odontoid Fractures

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Surgical versus Conservative Management for Odontoid Fractures

Shears, Armitstead·Cochrane Database Syst Rev·2008·47 citations·Systematic review

Free Full Text·DOI·PubMed

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Background

Fractures of the odontoid process of the second cervical vertebra can result in instability, neurological damage and death. Treatment includes conservative management (external immobilisation devices) or surgical treatment (internal fixation by posterior fusion or anterior screw fixation).

Purpose

To compare surgical with conservative treatment for fractures of the odontoid process.

Methods

Search Methods: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 3), MEDLINE (1950 to August Week 5 2010), EMBASE (1980 to 2010 Week 35), LILACS (September 2010), reference lists of articles and registries of ongoing trials.

Selection Criteria: Randomised and quasi-randomised controlled trials comparing surgical versus conservative treatment of odontoid fractures.

Data Collection and Analysis: Two review authors independently examined the search results to identify trials for inclusion.

Results

We identified an interim report of one study which appeared to meet our inclusion criteria but are awaiting further details from the trial authors before making a final judgment.
We excluded one registered study comparing surgery and conservative treatment which does not involve randomisation of treatment allocation.

Conclusions

There is no evidence available from adequately controlled trials to inform the decision on whether the surgical treatment of odontoid fractures gives a better outcome. A sufficiently powered good quality multicentre randomised controlled trial comparing surgery versus conservative treatment is warranted.

Copyright remains with the authors and publisher.

Surgical versus Conservative Management for Odontoid Fractures

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Surgical versus Conservative Management for Odontoid Fractures

Shears, Armitstead·Cochrane Database Syst Rev·2008·47 citations·Systematic review

Free Full Text·DOI·PubMed

|

Background

Fractures of the odontoid process of the second cervical vertebra can result in instability, neurological damage and death. Treatment includes conservative management (external immobilisation devices) or surgical treatment (internal fixation by posterior fusion or anterior screw fixation).

Purpose

To compare surgical with conservative treatment for fractures of the odontoid process.

Methods

Search Methods: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 3), MEDLINE (1950 to August Week 5 2010), EMBASE (1980 to 2010 Week 35), LILACS (September 2010), reference lists of articles and registries of ongoing trials.

Selection Criteria: Randomised and quasi-randomised controlled trials comparing surgical versus conservative treatment of odontoid fractures.

Data Collection and Analysis: Two review authors independently examined the search results to identify trials for inclusion.

Results

We identified an interim report of one study which appeared to meet our inclusion criteria but are awaiting further details from the trial authors before making a final judgment.
We excluded one registered study comparing surgery and conservative treatment which does not involve randomisation of treatment allocation.

Conclusions

There is no evidence available from adequately controlled trials to inform the decision on whether the surgical treatment of odontoid fractures gives a better outcome. A sufficiently powered good quality multicentre randomised controlled trial comparing surgery versus conservative treatment is warranted.

Copyright remains with the authors and publisher.

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