Comparison of Clinical Outcomes of Posterior C1-C2 Temporary Fixation Without Fusion and C1-C2 Fusion for Fresh Odontoid Fractures.
BACKGROUND
Posterior C1-C2 temporary-fixation technique can spare the range of motion (ROM) of the atlantoaxial joint after odontoid fracture healing. However, few studies analyze the difference in clinical outcome between this technique and posterior C1-C2 fusion technique for new odontoid fracture.


OBJECTIVE
To verify whether the clinical outcome of the posterior C1-C2 temporary-fixation technique is superior to that of the posterior C1-C2 fusion technique in the treatment of a new odontoid fracture.


METHODS
Twenty-one of 22 patients who underwent posterior C1-C2 temporary fixation of an odontoid fracture achieved fracture healing and regained motion of the atlantoaxial joint. The functional outcomes of these 21 patients were compared with that of a control group, which consisted of 21 randomly enrolled cases with posterior C1-C2 fixation and fusion. The differences between the 2 groups in the visual analog scale score for neck pain, neck stiffness, Neck Disability Index, 36-Item Short Form Health Survey, and time to fracture healing were analyzed.


RESULTS
Significantly better outcomes were observed in the temporary-fixation group for visual analog scale score for neck pain, Neck Disability Index, and neck stiffness. The outcomes in the temporary-fixation group was superior to those in the fusion group in all dimensions of the 36-Item Short Form Health Survey. There were no significant differences in fracture healing rate and time to fracture healing between the 2 techniques.


CONCLUSIONS
Functional outcomes were significantly better after posterior C1-C2 temporary fixation than after fusion. Temporary fixation can be used as a salvage treatment for an odontoid fracture with an intact transverse ligament in cases of failure of, or contraindication to, anterior screw fixation.
‡Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China;§Department of Orthopaedics, Shanghai Corps Hospital, Chinese People's Armed Police Forces, Shanghai, People's Republic of China.
Qunfeng
Q
Guo
Yuan
Y
Deng
Jian
J
Wang
Liang
L
Wang
Xuhua
X
Lu
Xiang
X
Guo
Bin
B
Ni
D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000379:methods / Q000639:trends*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000601:surgery; D009809:Odontoid Process / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome; D055815:Young Adult