![]() Fracture stability (41 studies, 1917 patients), although numerically favoring surgery, did not appear to differ between treatment groups. This difference remained after correcting for age and fracture type. However, fracture union was higher in surgically treated patients (pooled incidence 72.7%, 95% CI 66.1%, 78.5%, 31 studies, 988 patients) than in conservatively treated patients (40.2%, 95% CI 32.0%, 49.0%, 22 studies, 912 patients). No clinical differences in outcomes including the Neck Disability Index (NDI, 700 patients), Visual Analogue Scale pain (VAS, 180 patients), and Smiley-Webster Scale (SWS, 231 patients) scores were identified between surgical and conservative treatments. ![]() Resultsįorty-one studies met the inclusion criteria, of which forty were case series and one a cohort study. A random-effects multivariable meta-regression model was used to correct for baseline co-variates when sufficiently reported. Pooled point estimates and their respective 95% confidence intervals (CIs) were derived using the random-effects model. Fracture union- and stability were secondary outcomes. Clinical outcome was the primary outcome. MethodsĪ comprehensive search was conducted in seven databases. The objective of this review was to compare the outcome of surgical and conservative treatments in elderly (≥ 65 years), by updating a systematic review published by the authors in 2013. ![]() Odontoid fractures are the most common cervical spine fractures in the elderly, with a controversial optimal treatment.
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