A novel device of two-hole guide tube for percutaneous anterior odontoid screw fixation

English Keywords:Odontoid fracture  Percutaneous  Internal fixation  Minimally invasive

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical results of a novel device of two-hole guide tube for percutaneous anterior odontoid screw fixation. Methods: Twenty-two patients(18 males and 4 females) with odontoid fractures were treated by percutaneous anterior odontoid screw fixation with two-hole guide tube under fluoroscopic guidance. Their mean age at presentation was 40.5 years. Seventeen cases were Type Ⅱ and five were shallow Type Ⅲ fracture according to Anderson and D′Alonzo system. No displacement of fracture ending was noted in 6 cases, displacement of less than 5mm in 10 cases, over 5mm in 6 cases. The operation time, blood loss, fracture reduction, bone healing and complications were investigated. Results: The K-wire was confirmed to have a satisfactory angle and position after adjusting the K-wire at an ideal angle and position referring to the first one with the two-hole guide tube. The operation time was 35±12min and the blood loss was less than 20ml. Anatomical reduction of odontoid fractures occurred in 20 patients, and partial reduction in 2 patients. No complications associated with this technique occurred. Satisfactory results were achieved in all patients and all of the screws were in good position. Radiographic osseous union was documented in 21 of 22 patients after a follow-up of 16.7 months, and atlantoaxial stability was found in all patients. Neither clinical symptoms nor screw loosening or breakage occurred. Conclusions: The two-hole guide tube provides percutaneous anterior odontoid screw fixation procedure more feasible, quick and accurate placement of guide K-wire, thus ensures the accurate trajectory of odontoid screw.