Anterior odontoid lag screw fixation in type II odontoid fractures

Abstract

Odontoid fractures are common cervical spine fractures, lead to atlantoaxial instability, and constitute 10–20% of all cervical fractures. Almost two-thirds of all dens fractures are classified as type II according to the Anderson and D’ Alonzo classification system. An increased rate of nonunion of type II odontoid fractures with conservative measures has been reported. The technique of direct anterior screw fixation of the odontoid fracture has become increasingly popular since Bohler reported its use in 1982, and it is now widely used to treat type II. To evaluate the safety and efficacy of the anterior transodontoid screw fixation in odontoid fractures. Ten patients underwent anterior transodontoid single screw fixation for type II odontoid fractures according to the Anderson and D’ Alonzo classification system. All patients were operated on less than 3 months following trauma. All patients were males apart from one female with their ages ranging from 20 to 59 years with a mean age of 33.9 years. Patients were evaluated clinically and neurologically according to the American Spinal Injury Association scale, and radiologically using plain radiograph, computed tomography scan, and MRI. Good clinical and radiological (bony or fibrous) outcomes were achieved in all patients with no screw loosening, backing out, or proximal migration. There were no complications related to surgical procedure or neurological deterioration. Direct single anterior screw fixation has proved to be a very successful treatment method for type II odontoid fractures.