Odontoid fractures anterior screw fixation: a continuous series of 36 cases.
BACKGROUND
Fracture of the odontoid process represents 5 to 15% of cervical spine fractures. Anterior screw fixation is the reference technique in unstable posterior oblique or horizontal odontoid fracture.


OBJECTIVE
We describe results with an original anterior screw fixation technique using a curved thoraco-lumbar pedicle awl to facilitate intra-operative reduction.


METHODS
This is a retrospective study of 36 consecutive patients who underwent anterior screw fixation for odontoid process fracture. Mean age was 70.3 years. Twenty six patients had type II and 10 type III fracture on the Anderson-D'Alonzo classification. On the Roy-Camille classification, there were 34 posterior oblique fractures and two horizontal fractures. There were no anterior oblique fractures. Bony union was assessed on CT-scan at 3 months. We describe the surgical technique, which used a 4.5mm cannulated cancellous lag screw in all cases.


RESULTS
Mean follow-up was 3 years (range, 4 months to 8 years). No intra-operative complications were observed. Union rate was 95% and the average time to union was 5 months (3 to 6 months).


CONCLUSIONS
Anterior screw fixation is a common surgical treatment for posterior oblique and horizontal odontoid process fractures. We detail a reliable and reproducible intra-operative reduction maneuver to obtain a good union rate without complications.


METHODS
Level IV. Retrospective therapeutic study.
Eap
C
C
Maison Blanche University Hospital, Orthopedics and Traumatology Department, 45, rue Cognacq-Jay, 51100 Reims, France.
Barresi
L
L
Ohl
X
X
Saddiki
R
R
Mensa
C
C
Madi
K
K
Dehoux
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000293:injuries*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult