Type II odontoid fractures: Complication, mortality, and outcome after posterior C1-C2 fixation and fusion, single institute experience

Abstract

Background The aim of the present study was to evaluate long term C1-C2 fusion rates and functional outcomes in patients with type II odontoid fractures treated with posterior fixation with polyaxial C1 lateral mass and C2 pars screws. Methods A total of 32 patients were retrospectively evaluated. Study parameters included Japanese Orthopaedic Association (JOA) score and visual analog scale score for neck pain. All patients had computerized tomography (CT) scans preoperatively and at six months postoperatively; X-rays preoperatively and at three months and 12 months after operation Results Among the etiological factors, first (59.4%) fall from high and second (40.6%) traffic accidents have been observed. The duration of follow-up was 28.4 ± 8.5 months. A total of 25 patients had improvement on mean VAS score. A total of 12 patients had improvement at modified JOA score. No vascular injury occurred in our series. One patient (3.1%) developed hospital pneumonia, and the patient died at postoperative 6 th week. One patient (3.1%) had nonunion, but no neurological deficit was observed, and revision surgery was not needed 30 patients (93.8%) had fracture healing and fusion after posterior C1-C2 fixation. Conclusions In our opinion, posterior C1-C2 fixation and fusion is the treatment of choice in type II odontoid fractures with good fusion results. We achieved good results and low complication and mortality rates.