title: Trends in surgical management for type II odontoid fracture: 20 years of experience at a regional spinal cord injury center.
abstract: This study reviewed surgical treatment methods in patients with type II odontoid fracture who were admitted to a level 1 spinal cord injury center during a 20-year period. Of the 186 patients who met inclusion criteria, 75 were treated operatively. The rate of surgical intervention increased during the study period. Length of hospital stay was not related to treatment. Estimated blood loss was significantly higher for posterior techniques. The Brooks technique and anterior odontoid screw fixation declined in frequency, whereas the Magerl technique has been used at a consistent rate since its introduction. The C1 lateral mass and C2 pedicle/isthmus screw technique has increased significantly since its description. Pneumonia, vocal cord, and swallowing problems occurred more often with anterior approaches.
authors.affiliation: Department of Orthopedic Surgery, Thomas Jefferson University Hospital, 1015 Walnut St, Curtis Building, Room 801, Philadelphia, PA 19107, USA.
authors.forename: Harvey E
authors.initials: HE
authors.lastname: Smith
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: Mitchell
authors.initials: M
authors.lastname: Maltenfort
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Albert
authors.forename: Alan S
authors.initials: AS
authors.lastname: Hilibrand
authors.forename: D Greg
authors.initials: DG
authors.lastname: Anderson
authors.forename: James
authors.initials: J
authors.lastname: Harrop
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.forename: Branko
authors.initials: B
authors.lastname: Kopjar
authors.forename: Darrel S
authors.initials: DS
authors.lastname: Brodke
authors.forename: Paul M
authors.initials: PM
authors.lastname: Arnold
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Shaffrey
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008297:Male; D009809:Odontoid Process / Q000293:injuries*; D019637:Orthopedic Procedures / Q000706:statistics & numerical data / Q000639:trends*; D010414:Pennsylvania / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D016103:Spinal Fractures / Q000453:epidemiology* / Q000601:surgery*; D014193:Trauma Centers / Q000706:statistics & numerical data*