Original Article

Surgical Treatment of Acute Type II and Rostral Type III Odontoid Fractures Managed by Anterior Screw Fixation

Authors: Kostas N. Fountas, MD, PHD, Theofilos G. Machinis, MD, Eftychia Z. Kapsalaki, MD, PHD, Vassilios G. Dimopoulos, MD, Carlos H. Feltes, MD, Richard Liipfert, MS, Kim W. Johnston, MD, FACS, Hugh F. Smisson, MD, FACS, Joe S. Robinson, MD, FACS

Abstract

Objectives: In the present study, the authors comment on their experience with anterior odontoid screw fixation in the management of odontoid fractures, in an attempt to further assess the safety and the efficacy of this procedure.


Materials and Methods: A retrospective analysis of 50 consecutive patients with reducible type II or rostral type III odontoid fractures, operated at our hospital with anterior odontoid screw fixation. Radiographic bony fusion, complications, and clinical outcome were evaluated.


Results: Solid bony fusion was evident in 38 (90.5%) of the patients. One mechanical instrumentation-related complication occurred, without clinical significance. No other major complications related to the procedure were noted. A satisfactory range of motion in the cervical spine was observed in all patients.


Conclusions: Anterior odontoid screw fixation is a safe and effective procedure for the treatment of type II and rostral type III odontoid fractures. Compliance to the specific indications and contraindications of this operation is crucial for optimal outcome.


Key Points


* Anterior odontoid screw fixation is a safe procedure for the treatment of reducible type II and rostral type III odontoid fractures.


* High rates of bony union are associated with this anterior approach, comparable to those accomplished with posterior techniques.


* A satisfactory range of motion in the cervical spine is preserved with the anterior odontoid screw fixation technique, providing a good quality of life for the patient.

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