Clinical results and surgical options of fresh type Ⅱ odontoid fracture

English Keywords:Odontoid fracture  Screw fixation  Outcome

English Abstract:

  【Abstract】 Objective：To summarize the clinical results of anterior cannulated odontoid screw fixation and posterior C1-C2 screw-rods fixation for fresh type Ⅱ odontoid fracture.Method：From June 2002 to June 2010，84 cases with fresh type Ⅱ odontoid fracture treated surgically in our hospital were reviewed retrospectively.Among them，there were 56 males and 28 females，aged from 21 to 68 years old.All patients complained of neck pain and limited cervical ROM，and 17 cases presented with cervical spinal cord deficit.65 cases were complicated with atlantoaxial dislocation.After admission，all patients underwent skull traction and showed some degrees of atlantoaxial reduction.According to the fracture types and individual status，58 patients underwent cannulated odontoid screw fixation（group A），while 26 patients experienced C1-C2 screw-rods fixation（group B）.Result：No intraoperative vertebral artery injury and spinal cord injury were noted.All 84 patients were followed up for an average of 8 months（range，3-24 months）.54 of the 58 patients in group A got bony union，and 4 cases obtained fibrous healing.Cervical movement of patients in group A recovered to normal.All patients in group B got bony union，with some degree of limitation of the rotation.Conclusion：The management of fresh type Ⅱ odontoid fracture should be performed individually.Unicannulated odontoid screw fixation can maintain normal movement of cervical spine.