The prevalence of upper cervical spine fractures in the elderly is increasing as the population demographics change.  This is attributed to their predisposition to falls and the biochemical attrition associated with senile osteopenia. The injury patterns and management in the elderly are different from that of younger patients due to the difference in bone density, injury mechanism and presence of degenerative changes.

The treatment of these fractures is based on multiple factors that include fracture type, presence of associated injuries, comorbidities, timely diagnosis, reduction of the fracture, and toleration of immobilization.

This study evaluates the clinical effectiveness, long term results and cost-effectiveness of various treatment strategies for unstable odontoid fractures in elderly patients.