X-ray exposure in odontoid screwing for Anderson type II fracture: comparison between O-arm and C-arm-assisted procedures

Ricciardi, Luca; Montano, Nicola; D’Onofrio, Ginevra Federica; Polli, Filippo Maria; Latini, Marco; Bellesi, Alessandro; Biovi, Fabio; Olivi, Alessandro; Sturiale, Carmelo Lucio

doi:10.1007/s00701-019-04108-8

Cited by 9 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[6][7][8]11 When compared with posterior approaches, anterior odontoid screw placement for Anderson type II fractures reported better surgical outcomes in terms of intraoperative blood loss and surgical duration, as well as lower risks for posterior approach-related complications such as CSF leak, vertebral artery injuries, and prone position-related risks, especially in elderly patients. 3,10,11,23 This represents a minimally invasive approach through the cervical fascial planes, which requires a mild soft-tissue retraction and preserves the C1-2 range of motion. [9][10][11]24 However, it re-mains an ultra-specialist procedure that requires specific training and is associated with nonnegligible risks for vascular, nervous system, and dural injuries.…”

Section: Discussionmentioning

confidence: 99%

“…3,10,11,23 This represents a minimally invasive approach through the cervical fascial planes, which requires a mild soft-tissue retraction and preserves the C1-2 range of motion. [9][10][11]24 However, it re-mains an ultra-specialist procedure that requires specific training and is associated with nonnegligible risks for vascular, nervous system, and dural injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, fusion should be always pursued, whereas no residual instability may represent a satisfactory suboptimal result. 1,10,12,13 In contrast, anterior odontoid screw placement allows one to preserve the segmental mobility and obtain nonresidual instability, which could represent the best clinical-radiological outcome.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] The anterior cervical approach for dens screw placement was first reported by Böhler in 1982; it has been increasingly preferred to posterior and anterior C1-2 fusion techniques due to its surgical advantages and to the possibility of preserving segmental range of motion. [9][10][11] Achieving no residual instability has been proposed as the treatment goal after Anderson type II fractures. 1,12 Although often ABBREVIATIONS CVJ = craniovertebral junction.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study

Ricciardi

Trungu

Scerrati

et al. 2021

Journal of Neurosurgery: Spine

Self Cite

View full text Add to dashboard Cite

OBJECTIVEAnderson type II odontoid fractures are severe conditions, mostly affecting elderly people (≥ 70 years old). Surgery can be performed as a primary treatment or in cases of failed conservative management. This study aimed to investigate how duration from injury to surgery, as well as clinical, radiological, and surgical risk factors, may influence the union rate after anterior odontoid screw placement for Anderson type II odontoid fractures.METHODSThe authors conducted a retrospective multicenter study. Demographic, clinical, surgical, and radiological data of patients who underwent anterior odontoid screw placement for Anderson type II fractures were retrieved from institutional databases. Study exclusion criteria were prolonged corticosteroid drug therapy (> 4 weeks), polytraumatic injuries, oncological diagnosis, and prior cervical spine trauma.RESULTSEighty-five patients were included in the present investigation. The union rate was 76.5%, and 73 patients (85.9%) did not report residual instability. Age ≥ 70 years (p < 0.001, OR 6), female gender (p = 0.016, OR 3.61), osteoporosis (p = 0.009, OR 4.02), diabetes (p = 0.056, OR 3.35), fracture diastasis > 1 mm (p < 0.001, OR 8.5), and duration from injury to surgery > 7 days (p = 0.002, OR 48) independently influenced union rate, whereas smoking status (p = 0.677, OR 1.24) and odontoid process angulation > 10° (p = 0.885, OR 0.92) did not.CONCLUSIONSAlthough many factors have been reported as influencing the union rate after anterior odontoid screw placement for Anderson type II fractures, duration from injury to surgery > 7 days appears to be the most relevant, resulting in a 48 times higher risk for nonunion. Early surgery appears to be associated with better radiological outcomes, as reported by orthopedic surgeons in other districts. Prospective comparative clinical trials are needed to confirm these results.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study

Ricciardi

Trungu

Scerrati

et al. 2021

Journal of Neurosurgery: Spine

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, percutaneous pedicle screw implantation is associated with a high incidence of iatrogenic facet joint violation (FJV), which is an independent risk factor for adjacent segment disease (ASD) [2][3][4]. In addition to these patient-related disadvantages, the surgeon's intraoperative radiation exposure is becoming increasingly concerning [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Robot-Assisted Percutaneous Pedicle Screw Placement Under Regional Anaesthesia: A Comparative Cohort Study

Gao

Wei

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Robot-assisted pedicle screw placement is usually performed under general anaesthesia to keep the body still. The aim of this study was to compare the accuracy of the robot-assisted technique under regional anaesthesia with conventional fluoroscopy-guided percutaneous pedicle screw placement under general anaesthesia in minimally invasive lumbar fusion surgery.Methods: Patients who underwent robot-assisted percutaneous endoscopic lumbar interbody fusion (PELIF) or fluoroscopy-guided minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) from December 2017 to February 2020 in a single centre were included. Based on the method of percutaneous pedicle screw placement used, patients were divided into the robot-assisted under regional anaesthesia (group RE-RO) and fluoroscopy-guided under general anaesthesia (group GE-FLU) groups. The primary outcome measures were screw accuracy and the incidence of facet joint violation (FJV). Secondary outcome measures included X-ray exposure and intraoperative adverse events.Results: Eighteen patients were included in group RE-RO, and 23 patients were included in group GE-FLU. The percentages of clinically acceptable screws (Gertzbein and Robbins grades A and B) were 94.4% and 91.5%, respectively. There was no significant difference in the percentages of clinically acceptable screws (p=0.44) or overall Gertzbein and Robbins screw accuracy grades (p=0.35). Only the top screws were included in the analysis of FJVs. The percentages of FJV (Babu grades 1, 2 and 3) were 5.6% and 28.3%, respectively. This difference was statistically significant (p=0.01). Overall, the FJV grades in group RE-RO were significantly better than those in group GE-FLU (p=0.009). The mean fluoroscopy time for each screw in group RE-RO was significantly shorter than that in group GE-FLU (group RE-RO, 5.4±1.9 seconds, group GE-FLU, 6.8±2.0 seconds; P=0.03). The intraoperative adverse events included 1 case of registration failure and 1 case of guide-wire dislodgment in group RE-RO as well as 2 cases of screw misplacement in group GE-FLU. No complications related to anaesthesia were observed.Conclusion: Robot-assisted pedicle screw placement under regional anaesthesia can be performed effectively and safely. The accuracy is comparable to the conventional technique. Moreover, this technique has the advantage of fewer FJVs and a lower radiation time.

show abstract

Referencing for anterior atlantoaxial trans-articular osteosynthesis: a radiological study and proposal of a decisional algorithm

et al. 2022

View full text Add to dashboard Cite

X-ray exposure in odontoid screwing for Anderson type II fracture: comparison between O-arm and C-arm-assisted procedures

Cited by 9 publications

References 27 publications

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study

Accuracy of Robot-Assisted Percutaneous Pedicle Screw Placement Under Regional Anaesthesia: A Comparative Cohort Study

Referencing for anterior atlantoaxial trans-articular osteosynthesis: a radiological study and proposal of a decisional algorithm

Contact Info

Product

Resources

About