title: [Cement-augmented anterior odontoid screw fixation of a Anderson-D'Alonzo type II fracture with massive osteoporosis. Case report].
abstract: Anterior screw fixation is a standard treatment procedure in the case of an uncomplicated Anderson-D'Alonzo type II odontoid fracture in younger patients. Insufficient bony screw hold can cause severe procedure-related complications and result in screw breakouts with secondary fracture dislocation. Hence, the procedure is limited to patients with an adequate bone mineral density. This case report summarises a technical modification of anterior screw fixation in elderly patients suffering from severe osteoporosis to avoid a posterior spondylodesis of C1/2. Two patients with odontoid fractures of Anderson-D'Alonzo type II were operated using anterior screw fixation and additional vertebroplasty of C2 to increase the screw hold. During follow-up a regular bony healing without screw complication was observed. In conclusion, cement-augmented anterior screw fixation of odontoid fractures type II according to Anderson-D'Alonzo and persistent severe osteoporosis can be an alternative to posterior C1/2 spondylodesis in individual cases.
authors.affiliation: Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, Berufsgenossenschaftliche Unfallklinik Frankfurt, Frankfurt am Main. matti.scholz@bgu-frankfurt.de
authors.forename: M
authors.initials: M
authors.lastname: Scholz
authors.forename: K J
authors.initials: KJ
authors.lastname: Schnake
authors.forename: R
authors.initials: R
authors.lastname: Hoffmann
authors.forename: F
authors.initials: F
authors.lastname: Kandziora
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D001843:Bone Cements; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D016103:Spinal Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty / Q000379:methods*; D020535:Video-Assisted Surgery / Q000379:methods
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate