[Therapeutic effects and complications of percutaneous anterior screw fixation for odontoid fractures].
OBJECTIVE
To investigate the therapeutic effects and complications of percutaneous anterior screw fixation for odontoid fractures.


METHODS
Twenty-eight patients with odontoid fractures, 21 males and 7 females, aged 38.6 (21-72), 12 with type II fractures and 16 with type III fractures, including 10 cases with shallow type III fractures, according to Anderson's classification system, underwent percutaneous anterior odontoid screw fixation with one screw implant. Five to seven days after the operation the patients got out of bed to conduct dirigation. Prostheses were used for 8-12 weeks post-operationally. The patients were followed up for 43.2 months (26-62 months). Radiological examination, including X-ray and CT examinations, and clinical examinations were carried out to observe the therapeutic effects.


RESULTS
Radiological examination showed bony union in 25 cases (89.3%), and non-union developed in 2 cases, 1 case was switched to posterior fusion surgery because of redisplaced fracture. The union rate was 83.3% in the type II fracture, and was 93.8% in the type III. Majority of the patients resumed an excellent cervical motion. No severe complication such as esophagus and carotid artery injury related with puncture was found. One patient had temporary superior laryngeal nerve paralysis, The screw tail was detained at the superior margin of C3 vertebral body in 5 cases, the screw penetrate the tip of odontoid process in 1 case, and the screw thread failed to pass the fracture site entirely in 1 case.


CONCLUSIONS
An innovative alternative method with the advantages of convenient procedure, less bleeding, gentle injury for surrounding tissue, and rapid recovery, percutaneous anterior odontoid screw fixation is similarly effective as open anterior odontoid screw fixation, for the treatment of odontoid fractures. Related complication is rare and not severe. The surgery has.
Ni
Wen-fei
WF
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, China.
Chi
Yong-long
YL
Xu
Hua-zi
HZ
Lin
Yan
Y
Wang
Xiang-yang
XY
Huang
Qi-shan
QS
Mao
Fang-min
FM
Wang
Sheng
S
D000328:Adult; D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000293:injuries; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*