title: Management of odontoid fractures with percutaneous anterior odontoid screw fixation.
abstract: Minimally invasive techniques have revolutionized the management of a variety of spinal disorders. The authors of this study describe a new instrument and a percutaneous technique for anterior odontoid screw fixation, and evaluate its safety and efficacy in the treatment of patients with odontoid fractures. Ten patients (6 males and 4 females) with odontoid fractures were treated by percutaneous anterior odontoid screw fixation under fluoroscopic guidance from March 2000 to May 2002. Their mean age at presentation was 37.2 years (with a range from 21 to 55 years). Six cases were Type II and four were Type III classified by the Anderson and D'Alonzo system. The operation was successfully completed without technical difficulties, and without any soft tissue complications such as esophageal injury. No neurological deterioration occurred. Satisfactory results were achieved in all patients and all of the screws were in good placement. After a mean follow-up of 15.7 months (range 10-25 months), radiographic fusion was documented for 9 of 10 patients (90%). Neither clinical symptoms nor screw loosening or breakage occurred. Our preliminary clinical results suggest that the percutaneous anterior odontoid screw fixation procedure using a new instrument and fluoroscopy is technically feasible, safe, useful, and minimally invasive.
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan Road, Wenzhou 325027, China. spinechi@126.com
authors.forename: Yong-Long
authors.initials: YL
authors.lastname: Chi
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Wang
authors.forename: Hua-Zi
authors.initials: HZ
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.forename: Qi-Shan
authors.initials: QS
authors.lastname: Huang
authors.forename: Fang-Min
authors.initials: FM
authors.lastname: Mao
authors.forename: Wen-Fei
authors.initials: WF
authors.lastname: Ni
authors.forename: Sheng
authors.initials: S
authors.lastname: Wang
authors.forename: Li-Yang
authors.initials: LY
authors.lastname: Dai
mesh_terms: D000328:Adult; D001863:Bone Screws; D005260:Female; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009809:Odontoid Process / Q000293:injuries*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D016896:Treatment Outcome