One or Two Screws in the Fracture of the Odontoid Process? Evaluation Using Computed Tomography

Abstract

Objective:To evaluate the bone area of the odontoid process through computed tomography and its relation with the area of one and two screws in the male and female subjects.Methods:188 CT scans of adults were analyzed. The isthmus area was selected and the transverse diameter was measured at 1.2 mm from the base of odontoid.Results:After placement of a screw, the odontoid area remains with 82% of free bone for both men and women. With two screws, 45.6% of women, had a free bone area of the odontoid process between 50% and 75% and 54.4% were above 75%. 26.6% men had percentage from 50% to 75% of free bone area and 73.4% above 75% (p=0.07). After the placement of two screws, the bone area was, in average, 77.3% in men and 75.4% in women. Using the Student t-test, the differences between the average of percentage of free bone area in men and women are significantly lower in women (p=0.0012).Conclusion:The pre-operative planning through CT can help to choose the number of screws in the odontoid process. The choice should be particularly careful when using two screws in women.