Management of odontoid fractures with percutaneous anterior odontoid screw fixation.
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.
Chi
Yong-Long
YL
Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan Road, Wenzhou 325027, China. spinechi@126.com
Wang
Xiang-Yang
XY
Xu
Hua-Zi
HZ
Lin
Yan
Y
Huang
Qi-Shan
QS
Mao
Fang-Min
FM
Ni
Wen-Fei
WF
Wang
Sheng
S
Dai
Li-Yang
LY
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