Spine Fractures in the Elderly

Spinal fractures in geriatric patients present a challenging set of problems for the treating surgeon. Issues of osteoporosis, pre-existing degenerative change and difficulties with imaging, make diagnosis challenging. Furthermore, elderly patients do not tolerate prolonged immobilization or extensive surgical procedures. Mechanical complications of internal fixation are frequent. This paper will review the challenges of caring for vertebral fractures in the elderly with particular focus on odontoid fractures, central cord syndrome, fractures in the previously ankylosed spine and internal fixation in osteoporotic bone.