title: Comparison of Atlantoaxial Rotation and Functional Outcomes of Two Nonfusion Techniques in the Treatment of Anderson-D'Alonzo Type II Odontoid Fractures.
abstract: METHODS
  A retrospective comparative study.
  
  
  OBJECTIVE
  The aim of this study was to compare the outcomes of anterior screw fixation and posterior temporary-fixation in the treatment of Anderson-D'Alonzo type II odontoid fractures.
  
  
  BACKGROUND
  Posterior C1-C2 temporary-fixation can spare the motion of C1-C2 in the treatment of odontoid fractures. However, it is unknown whether it can achieve the same outcomes as anterior screw fixation.
  
  
  METHODS
  Data of 20 patients who underwent posterior temporary-fixation due to Anderson-D'Alonzo type II odontoid fractures with intact transverse ligament were retrospectively reviewed. Another 20 patients undergoing anterior screw fixation were randomly selected as the control group. The range of motion (ROM) in rotation of C1-C2 measured on functional computed tomography (CT) scan and outcomes evaluated by the visual analog scale (VAS) for neck pain, neck stiffness, patient satisfaction, and neck disability index (NDI) were compared between two groups at the final follow-up.
  
  
  RESULTS
  At the final follow-up, 19 cases in each groups achieved facture healing. Total C1-C2 ROM in rotation on both sides in the posterior temporary-fixation group was 32.4 ± 12.5°, smaller than 40.0 ± 13.0 in the anterior fixation group. However, there was no statistical difference between two groups. And there was no significant difference between two groups in functional outcomes evaluated by VAS for neck pain, neck stiffness, patient satisfaction, and NDI.
  
  
  CONCLUSIONS
  Posterior temporary-fixation can spare the motion of C1-C2 and achieve same good clinical outcomes as anterior screw fixation in the treatment of Anderson-D'Alonzo type II odontoid fractures. It was an ideal alternative strategy to anterior screw fixation.
  
  
  METHODS
  3.
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Qunfeng
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Traditional Chinese Medicine Rehabilitation, Zhabei Central Hospital, Shanghai, People's Republic of China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Xuhua
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Ni
mesh_terms: D000328:Adult; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012399:Rotation; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome