![]() ![]() The fractures were caused by a motor vehicle collision in 21 cases and by a fall in 11 cases. There were 19 males and 13 females between 16 and 101 years old (mean, 41 years). This article reviews our experience with anterior odontoid screw fixation for Type II odontoid fractures.īetween 19, 32 patients who sustained Type II fractures of the odontoid process underwent anterior odontoid screw fixation. In contrast, anterior odontoid screw fixation provides immediate stability, preserves normal rotation at C1 C2, and usually obviates the need for halo immobilization after surgery. 2,8,10 C1 C2 posterior transarticular screws added to the wiring techniques eliminate the need for postoperative halo immobilization but also sacrifice normal rotation at this level. Surgical treatment for Type II odontoid fractures with posterior C1 C2 wiring methods is associated with a fusion rate of 97% but requires halo immobilization for 3 months after surgery and sacrifices all C1 C2 motion. Type III fractures extend into the body of C2. Type II fractures are across the base of the dens. Type I fractures are at the apex of the dens. Anderson and D’Alonzo’s1 classification of odontoid fractures. 17 The difficulty in obtaining union of a Type II odontoid fracture through halo immobilization has been attributed to disruption of the precarious blood supply of the odontoid process, free floating of the fractured odontoid bone in the surrounding synovial cavities, and limited contact between the two cancellous surfaces of the fracture. 3,9 Type IIA fractures (comminuted), an odontoid Type II fracture with bone fragments at the base of the odontoid, have a 100% failure rate when treated with a halo brace. 13 When treatment is delayed more than 1 week, a patient is older than 60 years, the displacement is anterior, or all three conditions exist, these fractures have been associated with even higher rates of nonunion. Odontoid Type II fractures displaced more than 6 mm (anteriorly or posteriorly) have a 78% chance of failure when treated with a halo brace. Open surgical reduction and fixation are required for widely displaced fractures. 1).13Halo immobilization is the preferred treatment for fractures displaced less than 6 mm. Key Words : atlantoaxial instability, cervical spine instability, odontoid fracture, odontoid screw fixationĪlmost two thirds of all dens fractures are Type II odontoid fractures or fractures that extend across the neck of the dens (Fig. This is the only spinal fixation technique for fractures that restores spinal stability yet completely preserves normal spinal motion. It is associated with excellent clinical results and a high rate of fusion. Odontoid screw fixation is the preferred method for stabilization of acute, unstable Type II odontoid fractures. Thirty-two patients who sustained Type II fractures of the odontoid process were surgically treated with anterior odontoid screw fixation. †University Hospital of Patras, Patras, Greece 2, 1997 / Odontoid Screw Fixationĭivision of Neurological Surgery, Barrow Neurological Institute, Mercy Healthcare Arizona, Phoenix, Arizona Home / For Providers & Researchers / Education / Grand Rounds, Publications, & Media / Barrow Quarterly / Volume 13, No. Department of Translational Neuroscience.Department of Physical Medicine & Neuro-Rehabilitation.Department of ENT and Skull Base Surgery. ![]() Barrow-ASU Center for Preclinical Imaging.Core Facilities and Biobank Show submenu.Bioskills & Neurosurgery Research Laboratory.Grand Rounds, Publications, & Media Show submenu.Neuroscience Fellowship Programs Show submenu.Rehabilitation Psychology Residency Program.Neuroscience Residency Programs Show submenu.Parkinson’s Disease & Movement Disorders.Center for Transitional Neuro-Rehabilitation. ![]()
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