Anterior Single Odontoid Screw Fixation for Type II Odontoid Fractures: In A Cohort Study of 11 Patients and literature review.

Yıl 2020, Cilt: 6 Sayı: 1, 1 - 5, 30.04.2020

Hüseyin Bozkurt , Densel Araç

https://doi.org/10.19127/mbsjohs.616788

Öz

Objective: We aim to demonstrate the fusion efficiency of anterior screw fixation technique in all types of type 2 odontoid fracture by presenting a study of 11 cases and updating the literature.
Methods: Retrospectively we analyzed 11 (8 males and 3 females) patients with type 2 odontoid fracture treated through anterior odontoid screw fixation in the Neurosurgery Department of XXX University Hospital between 2015 and 2018. All patient records were evaluated with current clinical, neurophysiological examination, radiological studies, and results. In operation we used retropharyngeal approach of Robinson and Smith and created a gutter in the superior edge of C3 corpus for proper trajection of screw. The patients were followed over a minimum period of eighteen months with a range (18-24 months). Assessments of the union, nonunion, screw displacement and overall, with complications were all recorded.
Results: 10 patients had no postoperative complication. Separation of odontoid fracture was observed in 1 patient after discharge from hospital, but during follow up period computerized tomography revealed fusion of the odontoid of the patient. Our patients had no any complication such as screw related problems, pseudo-arthrosis and dysphagia.
Conclusion: We recommend surgical treatment in all cases of type 2 odontoid fractures, including the anterior oblique fracture. The method used in our study is more reliable for trajection of screw and suitable for type 2 odontoid fracture, also fusion rate is higher than the other techniques

Anahtar Kelimeler

Odontoid, Fractures, Screw Fixation

Kaynakça

• Aebi M, Etter C, Coscia M: Fractures of the odontoid process. Treatment with anterior screw fixation. Spine 1989; 14(10): 1065-1070.
• Anderson LD, D’Alonzo RT: Fractures of the odontoid process of the Axis. J Bone and Joint Surg, 1974; 56(8): 1663-1674.
• Apfelbaum RI, Lonser RR, Veres R, Casey A. Direct anterior screw fixation for recent and remote odontoid fractures. Journal of Neurosurgery: Spine. 2000; 93(2):227-36
• Brooks AL, Jenkins EB. Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am. 1978; 60(3):279-84.
• Chi YL, Wang XY, Xu HZ, Lin Y, Huang QS, Mao FM, et al. Management of odontoid fractures with percutaneous anterior odontoid screw fixation. Eur Spine J 2007;16:1157–64.
• Dantas FL, Prandini MN, Caires AC, Fonseca GA, Raso JL. Management of odontoid fractures using anterior screw fixation: analysis of 15 cases. Arq Neuropsiquiatr 2002;60:823—29.
• Dickman CA, Foley KT, Sonntag VK, Smith MM: Cannulated screws for odontoid screw fixation and atlantoaxial transarticular screw fixation. Technical note. J Neurosurg 1995; 83(6):1095-1100.
• Fielding JW, Hawkins RJ, Ratzan SA. Spine fusion for atlanto-axial instability. J Bone Joint Surg [Am] 1976;58-A:400-407.
• Gallie WE. Fractures and dislocations of the cervical spine. Am J Surg. 1939; 46(3):495-9.
• Hadley MN, Walters BC, Grabb PA, Oyesiku NM, Przybylski GJ, Resnick DK, Ryken TC: lsolated fractures of the axis in adults. Neurosurgery 2002; 50 (3): 125-139
• Hanssen AD, Cabanela ME. Fractures of the dens in adult patients. J Trauma 1987;27:928-34.
• Kazan S, Tuncer R, Sindel M. Percutaneous anterior odontoid screw fixation technique. A new instrument and a cadaveric study. Acta Neurochir (Wien) 1999;141:521–24.
• Keskin F, Gomleksız C, SasanI M, Okte noglu T, Suzer T, Ozer AF . Clinical Results of Anterior Odontoid Screw Fixation for Type II Odontoid Fractures. Turk Neurosurg 2014; 24( 5):750-756.
• Koller H, Kammermeier V, Ulbricht D, Assuncao A, Karolus S, van den Berg B, et al. Anterior retropharyngeal fixation C1-2 for stabilization of atlantoaxial instabilities: study of feasibility, technical description and preliminary results. Europ Spine J. 2006; 15(9):1326-38.
• Lind B, Sihlbom H, Nordwall A. Halo vest treatment of unstable traumatic cervical spine injuries. Spine 1988;13:425-32.
• Matz PG, Ryken TC, Groff MW, et al.: Techniques for anterior cervical decompression for radiculopathy. J Neurosurg Spine. 2009; 11(2): 183–197.
• Mestdagh H, Vigier P, Berger M, Urvoy P. Results of atlantoaxial arthrodesis with posterior cerclage for fractures of the odontoid process: propos of 59 cases. Ann Chir 1988;42:492-500.
• Munakomi S, Tamrakar K, Chaudhary PK and Bhattarai B. Anterior single odontoid screw placement for type II odontoid fractures: our modified surgical technique and initial results in a cohort study of 15 patients 2016;5:1681.
• Pepin JW, Bourne RB, Hawkins RJ. Odontoid fracture, with special reference to the elderly patient. Clin Orthop 1985;193:178-83.
• Platzer P, Thalhammer G, Ostermann R, Wieland T, Vécsei V, Gaebler C. Anterior screw fixation of odontoid fractures comparing younger and elderly patients. Spine. 2007; 32(16):1714-20.
• Ryan MD, Taylor TKF. Odontoid fractures: a rational approach to treatment. J Bone Joint Surg [Br] 1982;64-B:416-21.
• Robinson RA, Smith GW. Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull John Hopkins Hosp 1955;96:223-24.
• Sonntag VK, H Dickman CA, Vardiman A. Anterior odontoid screw fixation. Principles of spinal surgery. New York: McGraw–Hill; 1996. 1039–49.
• Yılmaz A, Altas H. Incidental Findings on Cranial CT Scans of Children With Head Trauma .Annals of Medical Research 2019;26(6):1060-64.
• Wang G-J, Mabie KN, Whitehill R, Stamp WG. The nonsurgical management of odontoid fractures in adults. Spine 1984;9:229-30.