Markgroningen

Researchers are evaluating two treatment optionssurgery and rigid collar bracingfor unstable odontoid neck fractures in adults aged 70 years and older. These fractures are common in older adults and can affect mobility, independence, and quality of life. The study aims to determine which treatment leads to better recovery in daily living, pain, disability, and quality of life. This is a randomized controlled trial comparing surgical stabilization with conservative collar treatment for this population. Participants will be randomly assigned to either surgery involving posterior C1-C2 screw-rod fixation or conservative treatment using a rigid cervical collar for 12 weeks. Surgery typically lasts about 100 minutes with a hospital stay of approximately six days, while the collar group is monitored through patient diaries to track compliance. Those in the collar group may switch to surgery within 12 weeks if needed. Follow-up visits occur at about two weeks post-surgery, 12 weeks, and six months after treatment. During the study, participants will complete questionnaires assessing daily function, pain, and quality of life. CT scans and other medical assessments will be performed, and collar use will be recorded for those in the conservative group. Researchers will monitor treatment adherence, complications, crossover rates, and healing progress. The main outcome measured is the change in the Barthel Index for daily living activities at 12 weeks, with additional evaluations at six months. The total study duration includes follow-up visits up to six months after injury.