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Journal of Neurosurgical Sciences 2001 March;45(1):15-8

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Single-screw fixation for acute Type II odontoid fracture

Alfieri A.

Division of Surgical Neurology, Regional Hospital, Bozen, Italy


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Background. The man­age­ment of odon­toid frac­tures is ­still con­tro­ver­sial. The ­main cur­rent ­trends of treat­ment are con­ser­va­tive man­age­ment ­with ­HALO immo­bil­iza­tion, pos­te­ri­or sur­gi­cal fix­a­tion or ante­ri­or sur­gi­cal fix­a­tion. The ­authors ­report a con­sec­u­tive ­series of 17 ­cases of ­patients ­with ­acute Type II odon­toid frac­ture treat­ed ­between November 1994 and February 2000.
Methods. Since June 1997 ante­ri­or odon­toid ­screw fix­a­tion was per­formed in ­nine cas­es. The tech­ni­cal ­aspects of the inter­nal ­fusion are ­described.
Results. Spinal sta­bil­iza­tion was ­achieved in all ­patients. The post­op­er­a­tive neu­ro­im­ag­ing dem­on­strates the suc­cess­ful posi­tion­ing of the odon­toid ­screw of all ­patients.
Conclusions. The suc­cess of ­this treat­ment ­depends on ­patients’ selec­tion, atten­tion to tech­ni­cal oper­a­tive ­details and ade­quate fol­low-up. Internal ­screw fix­a­tion ­gives imme­di­ate ­direct fix­a­tion of the frac­ture, ­offers a ­high ­rate of ­fusion with­out requir­ing pro­longed ­HALO immo­bil­iza­tion, it ­gives a reduc­tion of the cer­vi­cal ­pain and pre­serves the nor­mal mobil­ity of C1-C2.

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