Odontoid fracture types2/13/2024 Nine studies referred to complications, with a rate of 9.7%. Five articles referred to postoperative mortality, and the mortality rates of AA (5.0%) and PA (2.3%) showed no statistical difference ( P = 0.148). Subgroup analysis showed a difference in fusion rates between AA and PA in the elderly group. The average postoperative fusion rate was 77.5 ± 17.9% and 91.4 ± 13.5% in AA and PA, respectively, with statistical significance. Results: Twelve articles comrising 452 patients were included, and all publications were retrospective cohort studies. A meta-analysis of the primary outcomes and a systematic review of other outcomes were performed the procedure was conducted with Review Manager 5.3. Prospective or retrospective comparative studies on AA and PA for odontoid fractures were screened, referring to fusion rates (primary outcomes), complications, and postoperative mortality rates. Methods: The relevant studies were searched in PubMed/MEDLINE, Cochrane Library, EMBASE, China Biological Medicine (CBM), and Wanfang Database from the onset of conception to June 2022. Thus, a meta-analysis was performed comparing AA and PA for these fractures. Although the operation methods vary in different types, the superiority of overall outcomes of the anterior approach (AA) and posterior approach (PA) in treating odontoid fractures still remains controversial. 2Spinal Surgery, Peking University People’s Hospital, Beijing, Chinaīackground: Odontoid fractures account for 15%–20% of cervical injuries.1Spinal Surgery, Nanjing Lishui People’s Hospital, Nanjing, China.Xianguo Bao 1* Yingjun Chen 1* Chen Guo 2 Shuai Xu 2*
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