Percutaneous Anterior Odontoid Screw Fixation

Hk, Sucu; Akkol, İsmail; Minoğlu, Mustafa; Gelal, Fazıl

doi:10.1055/s-2007-1022543

Cited by 9 publications

(12 citation statements)

References 4 publications

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“…54 studies [12]–[20], [22]–[29], [31]–[51], [53]–[60], [62], [63], [65]–[70] that reported fusion results were pooled. Six studies [21], [52], [61], [72], [74], [75] were excluded from data synthesizing because of potential patients overlapping.…”

Section: Resultsmentioning

confidence: 99%

Pooled Analysis of Non-Union, Re-Operation, Infection, and Approach Related Complications after Anterior Odontoid Screw Fixation

Tian

et al. 2014

PLoS ONE

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BackgroundAnterior odontoid screw fixation (AOSF) has been one of the most popular treatments for odontoid fractures. However, the true efficacy of AOSF remains unclear. In this study, we aimed to provide the pooled rates of non-union, reoperation, infection, and approach related complications after AOSF for odontoid fractures.MethodsWe searched studies that discussed complications after AOSF for type II or type III odontoid fractures. A proportion meta-analysis was done and potential sources of heterogeneity were explored by meta-regression analysis.ResultsOf 972 references initially identified, 63 were eligible for inclusion. 54 studies provided data regarding non-union. The pooled non-union rate was 10% (95% CI: 7%–3%). 48 citations provided re-operation information with a pooled proportion of 5% (95% CI: 3%–7%). Infection was described in 20 studies with an overall rate of 0.2% (95% CI: 0%–1.2%). The main approach related complication is postoperative dysphagia with a pooled rate of 10% (95% CI: 4%–17%). Proportions for the other approach related complications such as postoperative hoarseness (1.2%, 95% CI: 0%–3.7%), esophageal/retropharyngeal injury (0%, 95% CI: 0%–1.1%), wound hematomas (0.2%, 95% CI: 0%–1.8%), and spinal cord injury (0%, 95% CI: 0%–0.2%) were very low. Significant heterogeneities were detected when we combined the rates of non-union, re-operation, and dysphagia. Multivariate meta-regression analysis showed that old age was significantly predictive of non-union. Subgroup comparisons showed significant higher non-union rates in age ≥70 than that in age ≤40 and in age 40 to <50. Meta-regression analysis did not reveal any examined variables influencing the re-operation rate. Meta-regression analysis showed age had a significant effect on the dysphagia rate.Conclusions/SignificancesThis study summarized the rates of non-union, reoperation, infection, and approach related complications after AOSF for odontoid factures. Elderly patients were more likely to experience non-union and dysphagia.

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Section: Resultsmentioning

confidence: 99%

Pooled Analysis of Non-Union, Re-Operation, Infection, and Approach Related Complications after Anterior Odontoid Screw Fixation

Tian

et al. 2014

PLoS ONE

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“…However, there has been several other anterior approaches described, all aiming at reducing the tissue dissection while accessing the desired entry point. [ 2 3 4 5 6 7 8 ]…”

Section: Discussionmentioning

confidence: 99%

“…The challenging learning curve and the potential risk for iatrogenic injury with error in the screw trajectory limit the wide clinical application of percutaneous anterior screw fixation. [ 2 3 4 5 6 ] Utility of minimally invasive approach to increase the safety is the need of the hour. There are few reports which suggest use of endoscope for odontoid screw placement but did not become popular because of lack of reproducibility.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic anterior odontoid screw fixation for the odontoid fracture: A cadaveric pilot study

Kedia¹,

Sawarkar²,

Mansoori³

et al. 2021

Asian J Neurosurg

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Introduction: Anterior odontoid screw fixation technique for specific types of odontoid fracture has been proven to be an effective, yet challenging procedure because of threatened damage to the structures in the vicinity. There are few articles suggesting the role of percutaneous and endoscopic technique as an alternative approach to the standard microscopic way. This is the first cadaveric study using existing “EASY GO” endoscopic system-assisted odontoid screw placement. Study Design: This was a cadaveric study. Objective: The objective of the study is to use the endoscope as a safer minimally invasive approach than the standard microscopic anterior approach to odontoid. Methodology: This is a pilot study on 10 fresh-frozen formalin-fixed adult human cadavers. The cadaver was positioned in a way to simulate reduced odontoid fracture. Tubular dilators were used to dock at C2–3 disk space after identifying the landmarks through the microscopic method. The EASY GO endoscopic system was then introduced, and a handheld drill was used to mark the entry point and pass the K-wire through the planned trajectory. Results: No vascular or adjacent vital structures' injury was observed in any of the cadavers. The initial difficulty in attaining the alignment was overcome by the appropriate positioning of the scope. Conclusions: Endoscopic-assisted technique for odontoid screw fixation shall provide a minimally invasive, safe, and easy surgery.

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“…Beside these common reasons, degenerative changes in the atlantoodontoid joint, severity of osteoporosis in the odontoid process, posterior oblique fracture type, sub-optimal fracture reduction, sub-optimal position of implant, quality of fracture compression and severity of fracture comminution may also effect the healing of the odontoid fracture (13)(14)(15)(16)19 We think that the K-wire insertion into the surface of the fractured part of the odontoid may help to trigger the osteoblasts. Osteoblastogenesis potential of the fractured bone may therefore increase (20). We think that this trigger procedure with K-wire is better than performing double transodontoid screw fixation for osteoporotic type II odontoid fractures.…”

Section: Discussionmentioning

confidence: 99%

Management of type ii odontoid fracture for osteoporotic bone structure: preliminary report

Coşar

Özer²,

Alkan³

et al. 2013

Turkish Neurosurgery

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AIm: Anterior transodontoid screw fixation technique is generally chosen for the management of type II odontoid fractures. The nonunion of type II odontoid fractures is still a major problem especially in elderly and osteoporotic patients. Eleven osteoporotic type II odontoid fracured patients were presented in this article. mATERIAl and mEThods:We have divided 11 patients in two groups as classical and Ozer's technique. We have also compared (radiologically and clinically) the classical anterior transodontoid screw fixation (group II: 6 cases) and Ozer's transodontoid screw fixation technique (group I: 5 cases) retrospectively.REsulTs: There was no difference regaring the clinical features of the groups. However, the radiological results showed 100% fusion for Ozer's screw fixation technique and 83% fusion for the classical screw fixation technique. CoNClusIoN:In conclusion, we suggest that Ozer's technique may help to increase the fusion capacity for osteoporotic type II odontoid fractures.

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Percutaneous Anterior Odontoid Screw Fixation

Abstract: Percutaneous anterior odontoid screw fixation is a minimally invasive and feasible surgical procedure.

Cited by 9 publications

References 4 publications

Pooled Analysis of Non-Union, Re-Operation, Infection, and Approach Related Complications after Anterior Odontoid Screw Fixation

Pooled Analysis of Non-Union, Re-Operation, Infection, and Approach Related Complications after Anterior Odontoid Screw Fixation

Endoscopic anterior odontoid screw fixation for the odontoid fracture: A cadaveric pilot study

Management of type ii odontoid fracture for osteoporotic bone structure: preliminary report

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