The Feasibility of Two Screws Anterior Fixation for Type II Odontoid Fracture Among Arabs

Marwan, Yousef; Kombar, Osama; Al-Saeed, Osama; Aleidan, Aljarrah; Samir, Ahmed; Esmaeel, Ali

doi:10.1097/brs.0000000000001351

Cited by 10 publications

(6 citation statements)

References 33 publications

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“…The treatment of upper cervical fractures includes conservative treatment (a halo-vest brace) and surgical treatment, depending on the remaining segmental stability. To obtain a stable fracture reduction and fixation and early mobilization, more and more surgical options were explored for the treatment of unstable upper cervical fractures, including odontoid anterior screw fixation, 18 posterior atlantoaxial pedicle screw fixation, 19 transoral atlantoaxial reduction plate fixation, 20 posterior C1/C2 trans-articular screw placement 21 and posterior occipitocervical fusion (OCF). 22 The CPS instrumentation represents the most rigid fixation, but it is a challenging procedure to even the most experienced surgeon.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of mixed reality–based intraoperative three-dimensional image-guided navigation for atlanto-axial pedicle screw placement

Liu

Song

et al. 2019

Proc Inst Mech Eng H

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This study aimed to evaluate the safety and accuracy of mixed reality–based intraoperative three-dimensional navigated pedicle screws in three-dimensional printed model of fractured upper cervical spine. A total of 27 cervical model from patients of upper cervical spine fractures formed the study group. All the C1 and C2 pedicle screws were inserted under mixed reality–based intraoperative three-dimensional image-guided navigation system. The accuracy and safety of the pedicle screw placement were evaluated on the basis of postoperative computerized tomography scans. A total of 108 pedicle screws were properly inserted into the cervical three-dimensional models under mixed reality–based navigation, including 54 C1 pedicle screws and 54 C2 pedicle screws. Analysis of the dimensional parameters of each pedicle at C1/C2 level showed no statistically significant differences in the ideal and the actual entry points, inclined angles, and tailed angles. No screw was misplaced outside the pedicle of the three-dimensional printed model, and no ionizing X-ray radiation was used during screw placement under navigation. It is easy and safe to place C1/C2 pedicle screws under MR surgical navigation. Mixed reality–based navigation is feasible within upper cervical spinal fractures with improved safety and accuracy of C1/C2 pedicle screw insertion.

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Section: Discussionmentioning

confidence: 99%

Feasibility of mixed reality–based intraoperative three-dimensional image-guided navigation for atlanto-axial pedicle screw placement

Liu

Song

et al. 2019

Proc Inst Mech Eng H

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“…Hence, contact stresses between them were generated, as seen in Figure 4, C-iii. These stresses have up to a 20% probability of causing an unstable type II odontoid fracture in the C2 dens or initiating cancellous bone cracks in C1 and facet joints [25]. In this case, the immediate intervention of anterior screw fixation surgical treatment is required to provide rigid support for the fracture and unify with the preservation of atlantoaxial rotation [25].…”

Section: Hyperextension Phasementioning

confidence: 99%

“…These stresses have up to a 20% probability of causing an unstable type II odontoid fracture in the C2 dens or initiating cancellous bone cracks in C1 and facet joints [25]. In this case, the immediate intervention of anterior screw fixation surgical treatment is required to provide rigid support for the fracture and unify with the preservation of atlantoaxial rotation [25]. Disruption of the ALL ligament occurred at C3-C5 levels due to exposure to tensile stresses beyond 30 MPa, which exceeds its material capabilities (Figure 5a).…”

Section: Hyperextension Phasementioning

confidence: 99%

Prediction of Neural Space Narrowing and Soft Tissue Injury of the Cervical Spine Concerning Head Restraint Arrangements in Traffic Collisions

2020

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Common quantitative assessments of neck injury criteria do not predict anatomical neck injuries and lack direct relations to design parameters of whiplash-protection systems. This study aims to provide insights into potential soft tissue-level injury sites based on the interactions developed in-between different anatomical structures in case of a rear-end collision. A detailed finite element human model has exhibited an excellent biofidelity when validated against volunteer impacts. Three head restraint arrangements were simulated, predicting both the kinematic response and the anatomical pain source at each arrangement. Head restraint’s contribution has reduced neck shear and head kinematics by at least 70 percent, minimized pressure gradients acting on ganglia and nerve roots less than half. Posterior column ligaments were the most load-bearing components, followed by the lower intervertebral discs and upper capsular ligaments. Sprain of the interspinous ligamentum flavum at early stages has caused instability in the craniovertebral structure causing its discs and facet joints to be elevated compressive loads. Excessive hyperextension motion, which occurred in the absence of the head restraint, has promoted a stable avulsion teardrop fracture of the fourth vertebral body’s anteroinferior aspect and rupture the anterior longitudinal ligament. The observed neck injuries can be mathematically related to head–torso relative kinematics. These relations will lead to the development of a comprehensive neck injury criterion that can predict the injury level. This, in turn, will impose a significant impact on the design processes of vehicle anti-whiplash safety equipment.

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“…Üst servikal bölgede instabilite varlığında; kırığın tipiyle birlikte cerrahın tecrübesine ve radyolojik olarak tespit edilen anatomik varyasyonlara bağlı olarak değişkenlik gösteren cerrahi tedavi seçenekleri mevcuttur. İlişkili olarak, anterior odontoid vidalama, posterior C1-C2 pedikül vidalama, posterior C1-C2 transartiküler vidalama ve posterior oksipitoservikal füzyon operasyonları yapılabilmektedir [23][24][25][26] . Özellikle C2 vertebra düzeyinde, vertebral arter veya pediküle ait anatomik varyasyonlarının eşlik ettiği durumlarda posterior translaminar vidalama tekniği de bir seçenektir 27 Bu çalışmada, dahil edilen hasta sayısının azlığı ve çalışma kohortunun heterojen olması nedeniyle daha ileri yorumlar yapılamamıştır.…”

Section: çAlışma Popülasyonuunclassified

Üst servikal vertebra travmalarında cerrahi tedavi sonuçları

Özay

Günaydin

Hanalıoğlu

et al. 2018

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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In this study, we aimed to evaluate surgical management strategies adopted in our clinic for the management of patients with upper cervical spine traumas. Materials and Methods: In this study, we retrospectively analysed clinical and radiological data of 12 patients with upper cervical spine traumas operated in our clinic between 2014 and 2016. The patients who underwent surgery for pathological fractures due to tumor, metastasis, or rheumatoid arthritis were excluded from the study. In all patients, diagnosis was made on the basis of cervical Xrays, computed tomography (CT) and magnetic resonance imaging (MRI). Results: The mean age of the patients (6 M, 6 F) was 46 years. High falls were the most common etiological cause in patients with upper cervical spine traumas. The most common pathology was type 2 odontoid fracture. Quadriparesis was observed in one patient, monoparesis in one patient and hypoglossal nerve palsy in one patient. All patients but one, who had anterior odontoid screw fixation, underwent upper cervical (C1-2) posterior segmental stabilization. No patient had additional neurological deficits postoperatively, one patient had surgical site infection (8.3%) and one patient was lost due to systemic complications (8.3%). Conclusion:In patients sustaining upper cervical spine trauma, immobilization with cervical collar or halo vest, anterior odontoid screw fixation and C1-2 posterior segmental stabilization are available management alternatives. Particularly, the awareness of anatomical variations and ligamentous injury with the aid of radiological images obtained via cervical spinal CT and MRI are critical to guide surgical technique. Amaç: Bu çalışmada üst servikal travmalı hastalarda yapmış olduğumuz cerrahi tedavi yöntemlerinin değerlendirilmesi amaçlanmıştır.. Gereç ve Yöntem: Bu çalışmada, 2014-2016 tarihleri arasında üst servikal travma nedeniyle opere edilmiş 12 hastanın verileri retrospektif olarak değerlendirildi. Kitle, metastaz veya romatoid artrit gibi patolojik fraktür nedeniyle opere edilmiş olan hastalar çalışma dışı bırakıldı. Tüm hastalarda tanı; servikal direk grafi, bilgisayarlı tomografi (BT) ve manyetik rezonans görüntüleme (MRG) ile gerçekleştirildi. Bulgular: Üst servikal travma nedeniyle opere edilen hastalar'da (6K, 6E, ortalama yaş; 46) etiyolojik nedenler arsında en sık etken yüksekten düşme tespit edildi. Yine en sık izlenen patoloji tip-2 odontoid fraktürü idi. Bir hastada kuadriparezi, bir hastada monoparezi ve bir hastada 12. Kranial sinir defisiti saptandı. Sadece bir hasta dışında (anterior odontoid vidalama-AOV) tüm hastalarda üst servikal (C1-C2) posterior segmental stabilizasyon (PSS) uygulandı. Hastaların hiçbirinde ek nörolojik defisit gelişmedi, bir hastada yara yeri enfeksiyonu gelişti (%8.3) ve bir hasta sistemik komplikasyonlar nedeniyle kaybedildi (%8.3). Sonuç: Üst servikal travmalı hastalarda, servikal kolar veya halo yelek ile mobilizasyon kısıtlaması, AOV veya C1-C2 PSS gibi cerrahi yöntemler tercih edilebilecek tedavi seçenekleridir. Özellikle servika...

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The Feasibility of Two Screws Anterior Fixation for Type II Odontoid Fracture Among Arabs

Abstract: 3.

Cited by 10 publications

References 33 publications

Feasibility of mixed reality–based intraoperative three-dimensional image-guided navigation for atlanto-axial pedicle screw placement

Feasibility of mixed reality–based intraoperative three-dimensional image-guided navigation for atlanto-axial pedicle screw placement

Prediction of Neural Space Narrowing and Soft Tissue Injury of the Cervical Spine Concerning Head Restraint Arrangements in Traffic Collisions

Üst servikal vertebra travmalarında cerrahi tedavi sonuçları

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