Anterior Screw Fixation for Odontoid Fracture Using the Direct Approach at the C2-C3 Level: Case Report and Literature Review

Campos, Wuilker Knoner; Sousa, Daniel dos Santos

doi:10.4172/2165-7939.1000162

Cited by 3 publications

(3 citation statements)

References 43 publications

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“…They claimed that this approach avoided excessive tissue damage by retraction or dissection and blind entry of the instruments. However, we found the trajectory through the high incision somewhat problematic with our non-angled instrument set [9]. In spite of being less cosmetically accepted, we found that using a longitudinal incision had the advantages of both low and high incisions.…”

Section: Discussionmentioning

confidence: 68%

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Placement of a single anterior odontoid screw for type II odontoid fractures in a setting with limited resources

Ashry

Aboul-Ela

2019

Egypt J Neurol Psychiatry Neurosurg

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Background: Treatment of odontoid fractures with odontoid screws is an established method for fusion. However, it is facilitated by using advanced equipment in the operating theatre not always available as in developing countries. Objectives: In this study we aim to outline the important key points for successful placement of odontoid screw in the absence of advanced tools, e.g. navigation or O-arm. Materials and methods: Fifteen patients suffering from type II odontoid fractures were managed with single odontoid screw. Reduction of the fractures was achieved. A simple instrument set was used with the help of a single plane image intensifier. Longitudinal incision was used in 4 cases, and transverse incision was used in the remaining eleven cases. Anatomical identification of the midline helped to mark the entry point. The entry point used was millimetres below the anteroinferior edge of the axis vertebra. A short-headed screw was used. Results: Road traffic accident was the only mechanism of trauma reported in our study. All of the patients were neurologically intact. All of the patients remained neurologically intact after the procedure. There were no instances of wrong trajectory of the screw in our study. During follow-up, we found good union of all the fractures. Only 2 cases suffered from mild dysphagia. Conclusion: Fixation of odontoid fractures by anterior odontoid screws appears to be a safe and feasible procedure even in underequipped theatres. Anatomical knowledge helps in determining midline. Various modifications can help in overcoming shortcomings.

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Section: Discussionmentioning

confidence: 68%

“…Dysphagia usually occurs in the early postoperative period and decreases gradually. It may be related to retraction of pharynx and esophagus or dissection of soft tissues [9]. We tried to ameliorate this problem by loosening the retractor after introducing the k-wire.…”

Section: Discussionmentioning

confidence: 99%

Placement of a single anterior odontoid screw for type II odontoid fractures in a setting with limited resources

Ashry

Aboul-Ela

2019

Egypt J Neurol Psychiatry Neurosurg

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“…Of these 1820 cervical fractures, 340 (19%) were fractures of the axis, 74 (4%) were Hangman fractures, and 199 (59%) were odontoid fractures. A variety of treatment strategies have been proposed for odontoid fractures [8][9][10] and Hangman fractures. [11][12][13] Although treatment overall is controversial, the treatment of axis injuries with multiple fracture lines in particular has very little guidance in the literature and reports of these injuries are only descriptive.…”

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confidence: 99%