Treatment of Type II Odontoid Fractures Among the Elderly - Full Text View

Purpose

The purpose of this study is to compare the safety and effectiveness of surgical versus conservative management of type II odontoid fractures among patients > 64 years of age. Of secondary interest is to determine if there are differences in outcomes between anterior screw fixation and posterior fusion of these fractures.

Condition	Intervention	Phase
Neck Injuries Spinal Injuries	Procedure: surgical Procedure: conservative treatment	Phase IV

MedlinePlus related topics:

Fractures Neck Injuries and Disorders

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study

Official Title:	Comparing Surgical to Conservative Management in the Treatment of Type II Odontoid Fractures Among the Elderly

Further study details as provided by AO Clinical Investigation and Documentation:

Primary Outcome Measures:

Compare disease-specific health-related quality of life between the surgically and conservatively managed patients using the neck disability index [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Compare the proportion of patients with radiographic bony fusion between the surgically and conservatively managed patients [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Compare the rate of non-union between the surgically and conservatively managed patients [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Compare the rate of complications [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Compare the cervical range of motion between patients receiving anterior screw fixation, posterior fusion, and conservative management [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Identify risk factors for a poor outcome, independent of treatment intervention [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Estimated Enrollment:	166
Study Start Date:	December 2005
Estimated Study Completion Date:	August 2009
Estimated Primary Completion Date:	August 2008 (Final data collection date for primary outcome measure)

Intervention Details:

surgical treatment of odontoid fractures

conservative stabilization of fractures

Detailed Description:

Hypotheses are as follows:

Patients receiving surgical management will exhibit better disease specific health and general health related quality of life measures compared to those managed conservatively.
The rate of radiographic bony fusion will be greater among elderly patients receiving surgical fixation compared to patients receiving conservative management.
The rate of non union will be greater in the conservative group compared to the surgical group.
The complication rate will be higher in the surgical group due to the nature of the intervention though the rate of severe and serious complications will be low.

Eligibility

Ages Eligible for Study:	64 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

All new type II odontoid fractures including those in which the fracture line crosses into the body of C2
Age > 64
Stable and unstable fractures
< 3 months post-injury
No previous treatment for an odontoid fracture

Exclusion Criteria:

Pathological fractures unrelated to osteoporosis
Severe dementia or severe mental health problems
Participation in other trials or unlikely to attend follow-ups

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00266929

Contacts


Contact: Branko Kopjar, MD	206-221-3349	brankok@u.washington.edu

Locations


United States, Georgia
	Emory University SOM: Orthopedics	Recruiting
	Atlanta, Georgia, United States, 30329
	Contact: Tim Yoon, MD, PhD 404-778-7160
	Principal Investigator: Tim Yoon, MD, PhD

United States, Pennsylvania
	Spinal Cord Injury Center Thomas Jefferson University and The Rothman Institute	Recruiting
	Philadelphia, Pennsylvania, United States, 19107
	Contact: Alexander R Vaccaro, MD 267-339-3623 alexvaccaro3@aol.com
	Principal Investigator: Alexander R Vaccaro, MD

Sponsors and Collaborators

AO Clinical Investigation and Documentation

AOSpine North America

Investigators


Principal Investigator:	Alexander R Vaccaro, MD	Thomas Jefferson University and The Rothman Institute

More Information

Responsible Party:	AO Clinical Investigation of NA ( Judy He )
Study ID Numbers:	07-GOF-05
First Received:	December 19, 2005
Last Updated:	May 6, 2008
ClinicalTrials.gov Identifier:	NCT00266929
Health Authority:	United States: Institutional Review Board

Keywords provided by AO Clinical Investigation and Documentation:

odontoid fx

surgical intervention

conservative treatment

nonunion

odontoid fractures

surgical treatment

Study placed in the following topic categories:

Spinal Injuries

Fractures, Bone

Back Injuries

Wounds and Injuries

Disorders of Environmental Origin

Neck Injuries

ClinicalTrials.gov processed this record on September 04, 2008

Sponsors and Collaborators:	AO Clinical Investigation and Documentation AOSpine North America
Information provided by:	AO Clinical Investigation and Documentation
ClinicalTrials.gov Identifier:	NCT00266929