Surgical vs Nonoperative Treatment of Hadley Type IIA Odontoid Fractures

Aldrian, Silke; Erhart, Jochen; Schuster, Rupert; Wernhart, Simon; Domaszewski, Florian; Ostermann, Roman C.; Widhalm, Harald; Platzer, Patrick

doi:10.1227/neu.0b013e318235ade1.

Cited by 10 publications

(12 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our bony healing rate is reportedly lower than that reported in other series 2,4,5,10,13,16,19,20,22,23,25,26,32 ( Table 6). This may be related to a number of factors.…”

Section: Discussioncontrasting

confidence: 69%

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

Taha¹,

Facharzt

2012

Egyptian Spine Journal

View full text Add to dashboard Cite

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.

show abstract

“…Our bony healing rate is reportedly lower than that reported in other series 2,4,5,10,13,16,19,20,22,23,25,26,32 ( Table 6). This may be related to a number of factors.…”

Section: Discussioncontrasting

confidence: 69%

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

Taha¹,

Facharzt

2012

Egyptian Spine Journal

View full text Add to dashboard Cite

show abstract

“…The fusion rate of 95% after OS fixation in our series was comparable with the results in the available literature (87-100%). [6,13,14,18,[33][34][35] Many authors have recommended PF as the procedure of choice for the surgical approach in type IIA and type III fractures due to a slightly higher non-union rate associated with OS fixation. Our results of 95.8% and 100% fusion rates in type II and high type III fractures are comparable with the published literature.…”

Section: Discussionmentioning

confidence: 99%

“…Shrinivasan et al [40] could successfully place OS in 84.6% type II fractures with an 82% fusion rate. Aldrian et al (2011) [35] showed a good fusion rate of 87% after OS fixation in type IIA fracture and have also recommended it as the first line of management in comminuted odontoid fractures. Other authors, in a contrasting opinion, have recommended against utilizing an OS fixation in type IIA comminuted fractures due to the high non-union rates and have preferred the PF techniques.…”

Section: Discussionmentioning

confidence: 99%

“…[10,27,34] In our series, out of four patients with type IIA fracture who underwent OS fixation, three patients showed a good union while one patient, who developed non-union, was successfully managed by PF. A recommendation by Aldrian et al, [35] is that in type IIA fracture, the initial surgical procedure should be an anterior OS fixation; and, PF should be reserved for cases where the initial procedure fails. Apfelbaum (2000) [15] and Dantas (2002) [41] have advised against the placement of anterior OS in fractures with an anterior oblique fracture line due to the high non-union rates.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical management of odontoid fractures at Level one trauma center: A single-center series of 142 cases

et al. 2015

View full text Add to dashboard Cite

show abstract

“…1,7,12 Numerous studies have described the morbidity associated with this type of treatment, increasing to 66% for major complications. 25,44 Other studies have reported treatment with a rigid collar or a soft collar but for Type I or III fractures.…”

Section: Discussionmentioning

confidence: 99%

Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients

Terreaux¹,

Loubersac²,

Hamel³

et al. 2015

SPI

View full text Add to dashboard Cite

Anterior screw fixation is a well-recognized technique that is used to stabilize Type IIB fractures of the odontoid process in the elderly. However, advanced age and osteoporosis are 2 risk factors for pseudarthrosis. Kyphoplasty has been described in the treatment of lytic lesions in C-2. The authors decided to combine these 2 techniques in the treatment of unstable fractures of the odontoid. Two approximately 90-year-old patients were treated for this type of fracture. Instability was demonstrated on dynamic radiography in one patient, and the fracture was seen on static radiography in the other. Clinical parameters, pain, range of motion, 36-Item Short Form Health Survey (SF-36) score (for the first patient), and radiological examinations (CT scans and dynamic radiographs) were studied both before and after surgery. After inflating the balloon both above and below the fracture line, the authors applied a high-viscosity polymethylmethacrylate cement. Some minor leakage of cement was noted in both cases but proved to be harmless. The screws were correctly positioned. The clinical result was excellent, both in terms of pain relief and in the fact that there was no reduction in the SF-36 score. The range of motion remained the same. A follow-up CT scan obtained 1 year later in one of the patients showed no evidence of change in the materials used, and the dynamic radiographs showed no instability. This combination of kyphoplasty and anterior screw fixation of the odontoid seems to be an interesting technique in osteoporotic Type IIB fractures of the odontoid process in the elderly, with good results both clinically and radiologically.

show abstract

Surgical vs Nonoperative Treatment of Hadley Type IIA Odontoid Fractures

Cited by 10 publications

References 10 publications

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

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

Surgical management of odontoid fractures at Level one trauma center: A single-center series of 142 cases

Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients

Contact Info

Product

Resources

About