title: The Feasibility of Two Screws Anterior Fixation for Type II Odontoid Fracture Among Arabs.
abstract: METHODS
  Retrospective, cross-sectional study.
  
  
  OBJECTIVE
  To evaluate the feasibility of two screws anterior fixation of the odontoid process among Arab adults.
  
  
  BACKGROUND
  Anterior screw fixation is the treatment of choice for type II odontoid fractures. In order to perform the procedure safely, the diameter of the odontoid process should be wide enough to allow for the placement of one or two screws.
  
  
  METHODS
  A retrospective review of 156 computed tomography scans of the cervical spine was done. The included patients were Arabs, adults (at least 18 years old), and had no evidence of upper cervical spine trauma, deformity, infection, tumor, or surgery. The minimum external transverse diameter (METD), minimum internal transverse diameter (MITD), minimum external anteroposterior diameter (MEAD), and minimum internal anteroposterior diameter (MIAD) of the odontoid process were measured. A P value of ≤0.05 was considered as the cutoff level of statistical significance.
  
  
  RESULTS
  Our study included 94 (60.3%) males and 62 (39.7%) females. The mean age of the subjects was 37.8 ± 16.9 years (range 18-85). The mean values of the METD, MITD, MEAD, and MIAD were 8.7 ± 1.0 mm, 6.0 ± 1.1 mm, 10.3 ± 1.0 mm, and 7.4 ± 1.1 mm, respectively. Men had larger diameters compared to women. This was statistically significant for METD (P = 0.035) and MEAD (P < 0.001). The METD was <9.0 mm in 95 (60.9%) subjects, while the MITD was <8.0 mm in 153 (98.1%) subjects. These findings were not significantly different between males and females.
  
  
  CONCLUSIONS
  Two screws anterior fixation of type II odontoid fracture is not feasible among the majority of Arabs.
  
  
  METHODS
  3.
authors.affiliation: Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada.|Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Marwan
authors.affiliation: Department of Radiology, Al-Amiri Hospital, Kuwait City, Kuwait.|Department of Radiology, Mansoura University, Mansoura, Egypt.
authors.forename: Osama Rabie
authors.initials: OR
authors.lastname: Kombar
authors.affiliation: Department of Radiology, Al-Amiri Hospital, Kuwait City, Kuwait.|Department of Radiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
authors.forename: Osama
authors.initials: O
authors.lastname: Al-Saeed
authors.affiliation: Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.
authors.forename: Aljarrah
authors.initials: A
authors.lastname: Aleidan
authors.affiliation: Department of Radiology, Al-Amiri Hospital, Kuwait City, Kuwait.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Samir
authors.affiliation: Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait.|Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
authors.forename: Ali
authors.initials: A
authors.lastname: Esmaeel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018912:Arabs; D001863:Bone Screws; D005240:Feasibility Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult