One-Screw Fixation Provides Similar Stability to That of Two-Screw Fixation for Type II Dens Fractures

Feng, Gang; Wendlandt, Robert; Spuck, Sebastian; Schulz, Arndt P.

doi:10.1007/s11999-012-2389-1

Cited by 23 publications

(17 citation statements)

References 3 publications

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“…Biomechanical and clinical studies reported of no significant differences of single-screw or double-screw odontoid fixation [32,33]. In contrast, Dailey et al [34] retrospectively analyzed the efficacy of anterior OSF in a group of geriatric patients aged 70 or higher.…”

Section: Discussionmentioning

confidence: 99%

Anterior transarticular atlantoaxial screw fixation in combination with dens screw fixation for type II odontoid fractures with associated atlanto-odontoid osteoarthritis

Josten¹,

Jarvers²,

Glasmacher³

et al. 2016

Eur Spine J

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Section: Discussionmentioning

confidence: 99%

Anterior transarticular atlantoaxial screw fixation in combination with dens screw fixation for type II odontoid fractures with associated atlanto-odontoid osteoarthritis

Josten¹,

Jarvers²,

Glasmacher³

et al. 2016

Eur Spine J

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“…Placement of 2 screws yields a higher fusion rate in patients older than 70 years [6]. However, no difference in outcome or stability in the rest of patients was found [7,8]. In our situation, placing two screws is not feasible due to economic reasons.…”

Section: Discussionmentioning

confidence: 59%

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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“…We have used a single screw in our series. Biomechanical as well as clinical studies comparing one or two screws have confirmed the efficacy of a single screw in type II odontoid fractures 15,22,30 . A number of studies have reported complications related to Odontoid screw fixation, the incidence reported being as high as 24% of clinically relevant complications 4,29 .…”

Section: Discussionmentioning

confidence: 95%

Safety and Efficacy of Anterior Odontoid Screw for the Management of Odontoid Fractures. A Series of 22 Patients.

Taha¹,

Facharzt

2012

Egyptian Spine Journal

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Background Data: Several methods of treatment of odontoid fractures have been used. These have ranged from rigid immobilization to atlantoaxial fusion. Odontoid screw osteosynthesis is gaining popularity. Purpose: To define the efficacy and safety of odontoid screw fixation in the management of odontoid fractures and to report the clinical and radiological results. Study Design: A prospective cohort study of odontoid fractures treated with odontoid screw osteosynthesis. The study was conducted in Cairo university hospital, Egypt and AOA Neuro-spinal Centre, Libya in the period from January 2007 to October 2010. Patients and Methods: Over the period from January 2007 to October 2010, twenty two patients, 17 males and 5 females, with a mean age of 32.5 years were included in this study. These were 19 odontoid type-II and 3 shallow type-III fractures. All patients underwent odontoid screw fixation using a single screw. Results: Mean operative time was 80 minutes and mean blood loss 150 ml Patients were followed for a mean period of 20.6 months. Nineteen patients (87%) obtained a good or excellent result on the Smiley Webster scale. Fourteen patients (64%) obtained a bony union, 7 (32%) a stable fibrous union and one patient (4%) developed a pseudoarthrosis. One patient had a misplaced screw that was successfully revised and another patient had displacement of the screw with re-displacement of the fracture at three months follow up. He had removal of the screw and underwent atlanto-axial fusion. Conclusion: This study has proven the efficacy and safety of odontoid screw osteosynthesis in selected types of odontoid type II and shallow type III fractures. (2012ESJ024) Keywords: Odontoid fracture, upper cervical spine, odontoid screw fixation, anterior odontoid fixation, osteosynthesis of odontoid.

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One-Screw Fixation Provides Similar Stability to That of Two-Screw Fixation for Type II Dens Fractures

Abstract: One-screw fixation might be used as an alternative to two-screw fixation. Assumed BMD should not influence surgical decision making.

Cited by 23 publications

References 3 publications

Anterior transarticular atlantoaxial screw fixation in combination with dens screw fixation for type II odontoid fractures with associated atlanto-odontoid osteoarthritis

Anterior transarticular atlantoaxial screw fixation in combination with dens screw fixation for type II odontoid fractures with associated atlanto-odontoid osteoarthritis

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

Safety and Efficacy of Anterior Odontoid Screw for the Management of Odontoid Fractures. A Series of 22 Patients.

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