In Brief:
Using the Nationwide Inpatient Sample database, we report early complication rates and associated risk factors in patients with C2 fractures who underwent fusion or halo immobilization, using propensity score matching. Fusion patients had greater overall complication rates (20.2% vs. 10.1%, P < 0.0001) and resource utilization ($80,000 vs. $41,000, P < 0.0001) than halo patients. Both fusion and halo were associated with more than 3-fold increase in complication rates in patients aged 80 years or older.