A meta-analysis of the fusion rate from surgical treatment for odontoid factures: anterior odontoid screw versus posterior C1–C2 arthrodesis

Shen, Ye; Miao, Jinhao; Li, Chao; Fang, Lei; Cao, Samantha; Zhang, Ming; Yan, Jianhua; Kuang, Yong

doi:10.1007/s00586-015-3893-2

Cited by 36 publications

(33 citation statements)

References 42 publications

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“…Analyzing the possible reasons for surgical failure, inappropriate indications may be deteriorating. 3 , 4 , 13 , 30 , 32 - 36 …”

Section: Factors Influencing Treatment Indicationmentioning

confidence: 99%

“…Management options for odontoid fractures have expanded with advantages in imaging and surgical technologies, with a trend toward primary operative stabilization. 3 Initially strong indications with fracture displacement >5 mm, angulation >10°, and the presence of neurological deficits are widened also considering the potentially high morbidity, instability and secondary displacement in conservatively treated patients. 1 , 4 However, even operation results in nonunion rates of up to 33%.…”

Section: Introductionmentioning

confidence: 99%

“… 5 , 6 In a recently published meta-analysis, posterior C1/2 fusion resulted in significantly higher fusion rates in the elderly. 3 In younger patients, the potential loss of C1/2 motion should be taken into account, thus anterior direct osteosynthesis or temporary posterior stabilization using Harms technique are better options in this patient group. Despite numerous published articles over the past 2 decades.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

Gonschorek

Wähnert²,

Blattert

et al. 2018

Global Spine Journal

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Study Design:Narrative review.Objective:To establish recommendations for the treatment of odontoid fractures based on current literature and the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).Methods:Narrative review of the literature. Analyzing treatment algorithms of German trauma and spine centers as members of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).Results:There are many influencing factors leading to appropriate treatment of odontoid fractures such as age, bone quality, arthrosis, classification, and type of the fracture. Conservative nonoperative treatment is appropriate for stable undislocated displaced odontoid fractures. Anterior osteosynthesis with 1 or 2 screws leads to good results in the classical unstable type II odontoid fracture in patients with good bone quality. However, modifiers have been identified by the working group leading to higher complication and failure rates. For these cases, more stable constructs and/or posterior approaches are indicated.Conclusions:Operation seems to be standard treatment for odontoid fractures. However, in the aged population, conservative treatment should be considered as morbidity and mortality rise significantly in the group of >75 years. Conservative treatment may also be started within stable nondislocated fractures, but then regular controls have to be performed. If operation is indicated, many influencing factors have to be considered for appropriate approach and technique. The classification of Anderson and D’Alonzo is still standard. To create an adequate treatment algorithm, dislocation displacement and instability have to be identified. Stable odontoid fractures are treated conservatively non-operatively, but if so regular controls have to be performed. Unstable and/or dislocated displaced odontoid fractures are treated by anterior osteosynthesis with 1 or 2 screws. The technique is demanding and leads to elevated complication and failure rates if modifiers are apparent. In these cases, posterior instrumentation or fusion of C1 and C2 is favorable. In the aged population (>80 years), operative therapy is critical as postoperative morbidity complication and mortality rates rise significantly. As there is still some bias in the treatment algorithms, the working group recommends establishment of a prospective study to result in more objective statements.

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“…Analyzing the possible reasons for surgical failure, inappropriate indications may be deteriorating. 3 , 4 , 13 , 30 , 32 - 36 …”

Section: Factors Influencing Treatment Indicationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

Gonschorek

Wähnert²,

Blattert

et al. 2018

Global Spine Journal

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“…The commonest type of odontoid fracture is type 2 [1,2]. With the advances in imaging and surgical technologies, there is a trend toward primary operative stabilization [3]. In a recently published metanalysis, Posterior C1/2 fusion resulted in significantly higher fusion rates in the elderly [3].…”

Section: Introductionmentioning

confidence: 99%

“…With the advances in imaging and surgical technologies, there is a trend toward primary operative stabilization [3]. In a recently published metanalysis, Posterior C1/2 fusion resulted in significantly higher fusion rates in the elderly [3]. However, the loss of motion at the C1/2 joint in younger patients should always be taken into consideration.…”

Section: Introductionmentioning

confidence: 99%

Use of simultaneous traction over a halo ring to achieve reduction of a type 2 odontoid fracture for anterior odontoid screw fixation

Abolfotouh

Moore

2019

International Journal of Surgery Case Reports

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IntroductionOdontoid fractures are common. They represent 20% of all cervical trauma. There is a trend towards surgical stabilization. Fracture fixation with 1 or 2 anterior screws is standard operative treatment in younger population.Presentation of caseA case of type 2 odontoid fracture. The fracture was fixed initially with a halo vest temporarily. The patient was later treated operatively with anterior odontoid screw fixation. Reduction of the fracture was achieved using a bivector traction over a halo ring. The patient achieved an anatomical reduction and a rigid fixation.DiscussionType 2 odontoid fracture is very controversial to treat. Several methods of fracture reduction have been described in the literature including Gardner-Wells Tongs and Mayfield head clamp. To our knowledge, fracture reduction with biverctor traction over a halo frame hasn’t been described before in the literature.ConclusionBivector traction over a halo ring can be used for intraoperative reduction of odontoid fracture.

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Learning Curve in Surgical Treatment of Odontoid Fixation for a Series of Type II C2 Fractures

Maugeri

Iacopino

Giammalva³

et al. 2019

Acta Neurochirurgica Supplement

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A meta-analysis of the fusion rate from surgical treatment for odontoid factures: anterior odontoid screw versus posterior C1–C2 arthrodesis

Abstract: In light of these findings, we concluded that significant higher fusion rates were observed in patients who underwent posterior C1-C2 arthrodesis surgeries compared to those treated with anterior odontoid screw fixation.

Cited by 36 publications

References 42 publications

Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

Use of simultaneous traction over a halo ring to achieve reduction of a type 2 odontoid fracture for anterior odontoid screw fixation

Learning Curve in Surgical Treatment of Odontoid Fixation for a Series of Type II C2 Fractures

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