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and had minimum follow-up of two-years. Diagnosis, levels fused, rhBMP-2 dose, complications, and fusion (Lenke grade applied by two neuroradiologists) were assessed. Results: 53 patients (22 men/31 women) met inclusion criteria, with a mean age of 55.7 years and an average follow-up of 40 months. Surgical indications included basilar invagination (n=6), fracture (n=6), atlanto-axial instability (n=16), kyphosis/kyphoscoliosis (n=22), osteomyelitis (n=1), spondylolisthesis (n=1), cyst (n=1). 15 patients had confirmed rheumatoid disease. The average rhBMP-2

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orthosis, 2 with a Minerva brace, and 1 with a halo. Two patients required cervical surgery; an occipital cervical fusion for a type 2 odontoid fracture and one atlantoaxial fusion for atlantoaxial instability was performed. At the follow up appointments, none of the patients were found to have delayed instability based on clinical examination, upright x-rays or flexion-extension x-rays. Conclusion: All isolated OCF are likely stable injuries. Our data suggests all isolated OCF may be treated conservatively with any type of cervical orthosis and minimal follow up