Characteristics and Outcomes of Odontoid Fragility Fractures in Elderly

Overview

Usually, cervical spine fractures are not considered as osteoporotic fractures. However, recent studies show that odontoid fractures are the most common fractures of the cervical spine in elderly and may occur in a context of low trauma energy. Thus, the goal of this observationnal study is : – to describe the different type of odontoid fracture and to characterize bone status in elderly patient (>65 y) who underwent odontoid fracture in a context of low trauma energy. – To describe short and long term outcomes

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: January 2018

Detailed Description

All patients over 65 y admitted for low trauma odontoid fracture will be consecutively included in the study after informed consent. The investigators will record: – clinical risk factor of osteoporosis and health habits including accomodation – type of fracture and characterization of the odontoid fracture on imaging (standard X ray / MRI / QCT) – Bone status : bone mineral density on DXA, lab tests for secondary osteoporosis check-up, previous vertebral fracture on VFA or X ray – osteoporosis managment : nutrition, vitamin D, anti-osteoporotic drugs – treatment of the fracture : surgical / non surgical – adverse event during hospitalization – lenght of hospital stay – type of discharge Follow-up à 3 and 12 months : dead vs alive ; accomodation ; autonomy ; new fracture

Interventions

  • Other: observational
    • describe bone status and outcome of odontoid fracture

Clinical Trial Outcome Measures

Primary Measures

  • bone status at the time of odontoid fracture: bone mineral density, prevalent osteoporotic fracture, vitamin D status
    • Time Frame: from date of inclusion until to 3 weeks after the event. Inclusion will be proposed within 2 weeks after the fracture
    • clinical risk factor of osteoporosis, prevalent clinical osteoporotic fracture, bone mineral density measured by DXA, vertebral fracture assessment to detect other vertebral fracture, serum concentration in 25OHvitamin D

Secondary Measures

  • mortality
    • Time Frame: during hospitalization – 3 and 12 months after inclusion
    • mortality after odontoid fracture during hospitalization and at 3 and 12 monts
  • morbidity
    • Time Frame: during hospitalization – 3 and 12 months after inclusion
    • incident osteoporotic fracture, adverse event such as infection, cardiovascular event, neurological event
  • loss of autonomy
    • Time Frame: discharge, 3 and 12 months
    • lenght of hospital stay, type of discharge (home, nursing home, rehabilitation bed care, institutionalized accomodation

Participating in This Clinical Trial

Inclusion Criteria

  • all patients over 65 y admitted for low traumat odontoid fracture Exclusion Criteria:

  • patient < 65 y – traumatic odontoid fracture

Gender Eligibility: All

Minimum Age: 65 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Centre Hospitalier Universitaire de Nice
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • veronique breuil, MD, PhD, Principal Investigator, Centre Hospitalier Universitaire de Nice
  • Overall Contact(s)
    • veronique Breuil, MD PhD, 33 4 920 35 512, breuil.v@chu-nice.fr

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