Abstract
<jats:p>Introduction: Odontoid fractures represent a clinically significant subset of cervical spine injuries, with an increasing incidence among the elderly population. Understanding their demographic characteristics, fracture subtypes, and treatment outcomes is crucial for optimizing management strategies and guiding prevention efforts. Methods: This retrospective study included 65 patients with odontoid fractures treated between 2018 and 2023 at a tertiary neurosurgical center. Fractures were classified according to the Anderson and D’Alonzo system and further subclassified using the Grauer classification for Type II fractures. Clinical data, including age, mechanism of injury, fracture subtype, treatment modality, and radiologic outcomes, were analyzed. Results: The mean age of the cohort was 61.9 years, with 56.9% of patients aged ≥65 years. Low-energy ground-level falls were the most common mechanism of injury (50.7%), occurring predominantly in elderly patients. According to the Anderson and D’Alonzo classification, Type II fractures were the most frequent (53.8%), followed by Type III (44.6%). Among Type II fractures, 82.5% were Type IIB. Surgical treatment was performed in 33.8% of cases—most commonly anterior odontoid screw fixation—while 66.2% were managed conservatively. CT-based follow-up (n=42) demonstrated an overall osseous union rate of 76.1%. Fusion was achieved in 84.2% of surgically treated and 69.5% of conservatively treated patients. Patients younger than 65 years had a higher fusion rate (81.8%) compared with older patients (70%). Conclusion: Odontoid fractures are predominantly geriatric injuries, most often resulting from low-energy ground-level falls. Type II fractures, particularly the IIB subtype, remain the most common and carry a higher risk of nonunion. Surgical fixation provides superior fusion rates compared to conservative treatment. These results emphasize the importance of patient-specific management and suggest that future studies should further refine treatment algorithms in light of evolving surgical techniques and demographic trends.</jats:p>