[Choice of a technic of stabilization in surgical treatment of recent fractures of the odontoid process. 90 cases].
The objective of this study is to analyse the advantages and disadvantages of different surgical technics of odontoid process fracture stabilization. We try to find the best indications for each of them. We won't consider stable odontoid fractures which haven't treated by surgical therapy. A review of ninety acute dens fractures since 1979 has been analysed before 1985, the most of our injured person had a surgical stabilization by posterior approach. The analysis of our results had incited us, since that date, to vary our indications, by taking possibilities of anterior approach into consideration. So, have been realized 55 C1-C2 lacings, 20 of which with bone graft, 12 occipito-cervical arthrodesis, 10 screw fixations of odontoid process, 9 atlanto-axial arthrodesis by screw fixations, 2 posterior fixations by CD pediatric instrumentation, 1 Knodt instrumentation, 1 osteosynthesis by trans-oral exposure. Patients have been seen again, 1 month, 3 month, 6 month, 1 year later. Results have been estimated: Clinically by cervical mobility study in rotation and by local pain (16 excellent results, 24 good results, 27 middle results, and 23 bad results); Radiologically by analysis of specific complications of each technic (8 secondary removing, 6 incomplete deplacement corrections, 4 excessive corrections, 3 pseudarthrosis). We have regrouped global results technic by technic. We propose a therapeutic planning in which each technic can find the best result. The objective is to assure an effective retention by preserving movings of superior cervical spine.
Autricque
A
A
Service de Neurochirurgie B, Hôpital B, Lille.
Lesoin
F
F
Francke
J P
JP
Jomin
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001368:Axis, Cervical Vertebra / Q000293:injuries*; D005069:Evaluation Studies as Topic; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000293:injuries*; D013123:Spinal Fusion / Q000379:methods*
Choix d'une technique de stabilisation lors du traitement chirurgical des fractures récentes de l'odontoïde. 90 observations.