Anterior Single Odontoid Screw Fixation for Type II Odontoid Fractures: In A Cohort Study of 11 Patients and literature review.

Abstract

Objective: We aim to demonstrate the fusion efficiency of anterior screw fixation technique in all types of type 2 odontoid fracture by presenting a study of 11 cases and updating the literature. Methods: Retrospectively we analyzed 11 (8 males and 3 females) patients with type 2 odontoid fracture treated through anterior odontoid screw fixation in the Neurosurgery Department of XXX University Hospital between 2015 and 2018. All patient records were evaluated with current clinical, neurophysiological examination, radiological studies, and results. In operation we used retropharyngeal approach of Robinson and Smith and created a gutter in the superior edge of C3 corpus for proper trajection of screw. The patients were followed over a minimum period of eighteen months with a range (18-24 months). Assessments of the union, nonunion, screw displacement and overall, with complications were all recorded. Results: 10 patients had no postoperative complication. Separation of odontoid fracture was observed in 1 patient after discharge from hospital, but during follow up period computerized tomography revealed fusion of the odontoid of the patient. Our patients had no complication such as screw related problems, pseudoarthrosis and dysphagia. Conclusion:We recommend surgical treatment in all cases of type 2 odontoid fractures, including the anterior oblique fracture. The method used in our study is more reliable for trajection of screw and suitable for type 2 odontoid fracture, also fusion rate is higher than the other techniques