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Treatment of Type II Odontoid Fractures Among the Elderly
This study is currently recruiting participants.
Verified by AO Clinical Investigation and Documentation, August 2009
First Received: December 19, 2005   Last Updated: August 6, 2009   History of Changes
Sponsor: AO Clinical Investigation and Documentation
Collaborator: AOSpine North America
Information provided by: AO Clinical Investigation and Documentation
ClinicalTrials.gov Identifier: NCT00266929
  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

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

Resource links provided by NLM:


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 2010
Estimated Primary Completion Date: April 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Procedure: surgical
    surgical treatment of odontoid fractures
    Procedure: conservative treatment
    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

No publications provided

Responsible Party: NorConsult LLC ( Wynne Xie )
Study ID Numbers: 07-GOF-05
Study First Received: December 19, 2005
Last Updated: August 6, 2009
ClinicalTrials.gov Identifier: NCT00266929     History of Changes
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

Additional relevant MeSH terms:
Spinal Injuries
Back Injuries
Wounds and Injuries
Disorders of Environmental Origin
Neck Injuries

ClinicalTrials.gov processed this record on November 25, 2009