$posterior screw fixation odontoid fracture$ $posterior screw fixation odontoid fracture$

However, in type II odontoid process fractures with intact transverse ligament, anterior screw fixation provides the best morphological and functional results and is the treatment of choice. Type IIC fractures are usually treated by C1–C2 instrumental fusion. External immobilization is used when treating a minimally displaced type IIa fracture, while anterior screw fixation is usually used in displaced type IIa and IIb fractures.

$posterior screw fixation odontoid fracture$

A type III fracture extends from the base of the dens into the body of C2. in which the horizontal fracture pattern is type IIa, the anterosuperior to posteroinferior fracture pattern is type IIb, and the anteroinferior to posterosuperior fracture pattern is type IIc. A further subdivision of type II fractures has been described by Grauer et al. Type I fractures involve only the tip of the dens, while in type II fractures the neck of the dens is involved as well. The Anderson and D'Alonzo's categorization scheme divides odontoid fractures into three subtypes based on fracture morphology and healing potential which can help guide treatment. The procedure is less invasive than other techniques and provides clear direct visualization of the involved structures 2).ĭirect anterior screw fixation is an effective and safe method for treating recent odontoid fractures ( or = 18 months postinjury), a significantly lower rate of fusion is found when using this technique, and these patients are believed to be poor candidates for this procedure 3).Īlthough anterior screw fixation is the ideal choice for type Ⅱ odontoid fractures with anterior superior to posterior inferior fracture line, it may not be the best choice for comminuted or fracture end hardened type Ⅱ odontoid fractures 4).Odontoid fracture of the axis, a common cervical spine injury, is challenging because of the potential for additional injury during treatment due to the complex architecture of the cranio-cervical junction. Surgeons must be prepared to perform both procedures to adequately treat these injuries 1)įull-Endoscopic Anterior Odontoid Screw Fixation is a feasible and effective option for Odontoid fracture type II treatment. Although both anterior and posterior approaches are acceptable, many clinical and radiological factors should be taken into account when choosing the best surgical approach. However, this technique results in loss of atlantoaxial motion, requires prone positioning, and demands a longer operative duration than AOSF, factors that can be a challenge in patients with severe medical conditions. It is also used as a salvage procedure after failed AOSF. posterior occipitocervical fusion allows direct open reduction of displaced fragments and can reduce any atlantoaxial instability. posterior occipitocervical fusion has a higher rate of fusion and is indicated in patients with severe atlantoaxial misalignment and with poor bone quality. Additionally, older patients may have a higher rate of pseudarthrosis using this technique, as well as postoperative dysphagia. AOSF can preserve atlantoaxial motion, but requires a reduced odontoid, an intact transverse ligament, and a favorable fracture line to achieve adequate fracture compression. reviewed the literature about specific patients and fracture characteristics that may guide treatment toward one technique over the other. Anterior odontoid screw fixation indicationsĪnterior odontoid screw fixation (AOSF) and posterior occipitocervical fusion are both well-accepted techniques for surgical treatment but with unique indications and contraindications as well as varied reported outcomes.

$posterior screw fixation odontoid fracture$

Posterior screw fixation odontoid fracture