Houston Methodist. Leading Medicine

Neck FAQ

Question:

My father is 88-years-old but in relatively good health. He went out motorcycle riding with our 20-year-old grandson. Through no fault of their own, they had an accident. Pops ended up with a fracture of the odontoid process in his neck. I saw an X-ray of the fracture, but it all went by so fast. Could you tell us again what this means and how it will affect him?

Answer:

The odontoid is a bony knob or upward projection of bone on top of the second cervical vertebra (C2). C2 is also known as the axis. The odontoid process is also called the dens. The dens points up and fits through a hole in the first cervical vertebra (called the atlas). The joints of the axis give the neck most of its ability to turn to the left and right. A Type II odontoid fracture occurs right where the odontoid process attaches to the C2 vertebral body. This type of fracture is most common in older adults who fall or who have a motor vehicle accident and break off the odontoid in the cervical spine (neck). Treatment will be needed to stabilize the bone. If the fracture is nondisplaced (hasn't separated), then immobilization with a rigid cervical collar or brace may be all that's needed. Treatment can get a bit more complicated if the odontoid process has broken off completely. Without this piece of bone in place, the first two vertebral bones (the atlas and the axis) can slide apart. This puts a tremendous compressive or stretching force on the spinal cord as it goes down through the spinal canal. The spinal canal is a round opening or hollow tube formed by the vertebrae stacked on top of each other. With a displaced fracture, surgery is needed to bring the bones back together and hold them in place until healing (fusion or union) occurs. Results of treatment vary from patient to patient. The hope is that the patient will be pain free with a stable neck and restored function. But sometimes pain and loss of function can lead to disability. There's no way to predict ahead of time what kind of final results will occur for each patient. Age, general health, and the condition of the bones in older adults are just a few of the key factors that can affect the overall outcomes. Stabilizing the fracture and restoring function are the first two steps in the process. Healing and recovery from this type of injury can take weeks to months in an older adult. But the results can be good-to-excellent. Florentius Koech, MB, ChB, MMed (GSurgery), et al. Nonoperative Management of Type II Odontoid Fractures in the Elderly. In Spine. December 15, 2008. Vol. 33. No. 26. Pp. 2881-2886.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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