Delayed Pharyngeal Extrusion of an Anterior Odontoid Screw

Lee, Eun Jung; Jang, Jun Won; Choi, Seung Ho; Rhim, Seung Chul

doi:10.14245/kjs.2012.9.3.289

Cited by 17 publications

(39 citation statements)

References 18 publications

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“…Screw loosening and consequent pharyngeal perforation are an uncommon, but well recognized, occurrence for ventral cervical spine fusion operations in literature [ 13 – 16 ]. Although this complication has also been described after odontoid fixation [ 17 , 18 ], to the best of our knowledge this is the first case of transpharyngeal odontoid screw migration and spontaneous resolution via deglutition.…”

Section: Discussionmentioning

confidence: 74%

Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

Leitner

Bruckmann

Gilg

et al. 2017

Case Reports in Medicine

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Purpose. Anterior screw fixation has become a popular surgical treatment method for instable odontoid fractures. Screw loosening and migration are a rare, severe complication following anterior odontoid fixation, which can lead to esophagus perforation and requires revision operation. Methods. We report a case of screw loosening and migration after anterior odontoid fixation, which perforated the esophagus and was excreted without complications in a 78-year-old male patient. Results. A ventral dislocated anterior screw perforated through the esophagus after eight years after implantation and was excreted through the gastrointestinal (GI) tract. At a 6-month follow-up after the event the patient was asymptomatic. Conclusion. Extrusion via the GI tract is not safe enough to be considered as a treatment option for loosened screws. Some improvements could be implemented to prevent such an incident. Furthermore, this case is a fine example that recent preoperative imaging is mandatory before revision surgery for screw loosening.

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Section: Discussionmentioning

confidence: 74%

Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

Leitner

Bruckmann

Gilg

et al. 2017

Case Reports in Medicine

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“…They found out that placing the entry point above or anterior to the body had acceptable union rates [12]. However, this anterior position was linked in literature to the rare incidence of pharyngeal extrusion of the screw [13]. We prefer in our series to use of a short-headed screw.…”

Section: Discussionmentioning

confidence: 91%

“…Another cause for dysphagia is the close relationship of the esophagus and pharynx to the anterior odontoid screw. This may even cause their perforation, which could be fatal if not treated carefully with help from other specialties [13].…”

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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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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“…Osteopenia in elderly patients is a relative contraindication [14]. Rare complications with this approach are screw malposition, screw fracture, screw pull out [15].…”

Section: Discussionmentioning

confidence: 99%

Anterior Odontoid Screw Fixation for Type II Odontoid Fracture: Technical note

Rajan¹,

Brungi²,

Gafoor³

et al. 2016

JCR

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A 19 year-old boy presented with Type II odontoid fracture and subsequently underwent anterior odontoid screw fixation. Odontoid process fractures account for 10%-15% of all cervical fractures. Two thirds of all odontoid process fractures are type II according to the Anderson-D'Alonso classification. Anterior odontoid screw fixation provides osteosynthesis and hence best functional and anatomical outcome. In surgical approach skin incision is usually placed at the level of C5-C6, working pathway created to reach the C2 level. During entire surgical procedure simultaneous AP and lateral image intensifiers are required to facilitate the operating surgeon. High expertise and skill is required to prevent damage to the vital structures along with good theater set up. During this procedure there is high chance of iatrogenic injury to the vital structures like carotid artery, trachea and oesophagus.

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Delayed Pharyngeal Extrusion of an Anterior Odontoid Screw

Cited by 17 publications

References 18 publications

Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

Passage of an Anterior Odontoid Screw through Gastrointestinal Tract

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

Anterior Odontoid Screw Fixation for Type II Odontoid Fracture: Technical note

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