![]() The secondary endpoints are: EQ-5D score, activities of daily living (ADL), bony union, upper cervical stability and mortality. At 12 months, a dynamic radiographical investigation of upper cervical stability is performed. All participants are monitored with regard to the NDI, EuroQol score (EQ-5D), socio-demographics and computed tomography (CT) at the time of injury, at 6 weeks, 3 months and 12 months. The surgical group is treated with a posterior C1–C2 fusion. The non-surgical group is fitted with a rigid cervical collar for 12 weeks. By considering a 1-year mortality forecast of 29%, up to 25 participants are recruited in each group. A minimum of 16 patients are needed in each group to test the superiority with 80% power. The minimal clinically important difference of the NDI is 3.5 points. Excluded are patients with an American Society of Anaesthesiologists (ASA) score ≥ 4, dementia nursing care or anatomical cervical anomalies. ![]() Fifty consecutive patients aged ≥ 75 years, with displaced type-2 odontoid fracture, are randomised to non-surgical or surgical treatment. The Uppsala Study on Odontoid Fracture Treatment (USOFT) is a multicentre, open-label, randomised controlled superiority trial evaluating the clinical superiority of the surgical treatment of type-2 odontoid fractures, with a 1-year Neck Disability Index (NDI) as the primary endpoint. Due to the paucity of evidence, the treatment decision is often left to the discretion of the expert surgeon. ![]() Displaced odontoid fractures in the elderly are treated non-surgically with a cervical collar or surgically with C1–C2 fusion. ![]()
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